| Brain tumor is one of the most common diseases in Department of Neurosurgery,and the main research direction and hot point currently. Because of various tumors’different biological characteristics, their characteristics are different in imaging features,and therapy of brain tumor is mainly operation excision in Department of neurosurgerybesides radiotherapy and chemotherapy. Therefore, the understanding degree ofpreoperative tumor location, size, tumor surrounding tissue edema, and nerve fibertracts adjacent relations becomes extremely important, and becomes the key to thesuccess of the operation treatment, so the imaging diagnosis and treatment have becomean indispensable means in the process of diagnosis and treatment. In recent years,imaging methods have made considerable development. Among them, the magneticresonance diffusion tensor imaging (MR-DTI, DTI) has got a breakthrough progress,and attracted more and more attention to the doctors of department of neurosurgery. Itcan not only from the plane view of tumor location, size, tumor surrounding tissueedema, and nerve fiber tracts adjacent relations to observe tumors, namely fractionalanisotropy map (FA), but also can obtain the three-dimensional shape of fiber tract bythe software of three-dimensional imaging technology the software, namely the fibertractography (FT). By the imaging, we can successfully infer the different effects causedby tumor cells to pyramidal tracts at the microscopic level, as well as the range oftumors growth and adjacent relation with pyramidal tract at the macroscopic level,which can provides a powerful and objective basis for making operation scheme.Objective To explain the application value of preoperative diagnosis, grouping andgrading properly about gliomas, and the clinical significance of magnetic resonancediffusion tensor imaging used for protecting neurological functions in patients withbrain gliomas. Contents Collecting thirty-three patients with gliomas surgery-treated inneurosurgery department, General Hospital of Shenyang Military Area Commandduring December2011to June2012. All these cases underwent conventional magneticresonance imaging (MRI) test and magnetic resonance diffusion tensor imaging testbefore surgical operation. According to the adjacent relationships between gliomas andadjoining white matter tracts, it can be classified into three following types:displacement; infiltration; disruption. In the meantime, doctors evaluated the patients’status of neurological functions, and then had a horizontal comparison between thestatus of neurological functions and gliomas’ types. At last, on the basis of gliomas’types, we adopted different surgical operation strategy as follows: to contend vigorouslytotal resection to the displacement type; to adopt subtotal excision or partial resection tothe infiltration type; to enlarge the scope of resection to a certain extent properly. Aftersurgery, doctors evaluated the status of neurological functions again and recheckMR-DTI test instantly, compared gliomas’ types and postoperative status ofneurological functions; then had a comparison between patients’ status of neurologicalfunctions before surgery and after surgery.Methods These thirty-three patients with gliomas underwent MR-DTI and thestatus of neurosurgical functions before surgery and after surgery. According to theresults of MR-DTI, the adjacent relationships of gliomas and adjoining white mattertracts can be divided into the three following types: displacement; infiltration;disruption. The neurological functions before operation were compared in these threegroups, the change of neurological functions after operation was compared in thesethree groups, and the change of preoperative neurological functions and postoperativeneurological functions was also compared in these three groups.Results On the basis of the results of MR-DTI test, the adjacent relationships ofgliomas and adjoining white matter tracts can be divided into three following types:displacement; infiltration; disruption. There were twelve cases of displacement, twelvecases of infiltration, nine cases of disruption.(1)There were statistical significance indifferences between gliomas’ FA and contralateral normal brain tissue’ in the threetypes (P<0.05).(2)There were statistical significance in difference between DTI typesand preoperative neurological functions (P<0.05).(3)There were statistical significancein difference between DTI types and change of postoperative neurological functions(P<0.05).(4)There were statistical significance in differences in the preoperative statesof neurological functions and postoperative states of neurological functions. Conclusions MR-DTI can be applied in indicating the adjacent relationships ofgliomas and adjoining white matter tracts, which also can provide information aboutdifferent growth patterns of gliomas, then help the neurosurgeons to select more secureoperation approaches, surgical methods and the appropriate extent of tumors resection. |
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