| Objective:This research with functional magnetic resonance imaging for detection means study the patients with craniopharyngioma that from JiXing NanChang University Affiliated NO.1,and the research object agreed with treatment of craniopharyngioma by nasal endoscopic surgical removing;on the one hand,we want to cofirm the hypothalamus position that regulate water-electrolyte balance and appetite nucleus,moreover,to further analyze the nuclei and get a general idea of the relevant neural network regulating balance and appetite;On the other hand,we intend to evaluate the influence of hypothalamus damage and its corresponding function caused by endoscopic transnasal surgery,and the postoperative complications related to the damage of the hypothalamus nuclear group.Methods:From September 2016 to December 2017,we screened the 20 cases of craniopharyngeal tumor patients come from the first affiliated hospital of nanchang university and agreed to carry out surgical treatment by the inclusion criteria.At the same time,30 volunteers were screened according to the experimental needs(age and sex ratio were same with the patients with craniopharyngioma);Whereafter,by a magnetic resonance imager of 3.0T in our hospital,the subgroup(A/B)in the control group and the experimental group was performed in different functional states(1 and 2)respectively.Subgroups were: high concentration-saline group(A)and appetite group(B);Different states: the former was distilled water(1),hypertonic saline(2);The latter was anorexia(1)and appetite stimulation(2).All imaging data were pre-processed by statistical parametic mapping(SPM)software for spatial transformation,and then the functional brain activation diagrams were obtained under various state induction.Using Anatomatic Automatic Labeling software on brain activation signal is the strongest point in the graph space positioning;For the interested area that supraoptic nucleus,paraventricular nucleus and paraventricular pituitary beam,we used the MarsBar software to make correlation analysis.Results:In normal control group,the distilled water can be significantly activated hypothalamic supraoptic nucleus,paraventricular nucleus,the hypothalamus endplate,the arm nucleus,the solitary beam,periaqueductal gray,insula,anterior cingulate,median preoptic nucleus;In the comparison of anorexia and stimulation of appetite,it was found that the appetite-stimulating map could significantly induce the activation of the arcuate nucleus,nucleus accumbens,solitary nucleus,ventral nucleus,dorsal nucleus,and anterior cerebral striatum.In preoperative patients with craniopharyngioma postoperative contrast,so found under the same stimulation,the nucleus of interested region has obvious changes: preoperative results compared with normal group,show the similar signal of the strongest signal,or signal strength weakened,or shifted;After operation,compared to normal group,the presention was disappeared or severely weakened and slightly weakened.Conclusion:Hypothalamus plays an important role in osmotic pressure and appetite regulation.The main neural nuclei related to the former were: suprachiasmatic nucleus and ventricular nucleus;The main nuclei related to the latter were: arcuate nucleus,nucleus accumbens,dorsal nucleus and ventral nucleus.Craniopharyngioma is adjacent to the hypothalamus,so patients of postoperative urine collapse late and the generation of the hypothalamus obesity may be related to the operation process that damaged or stimulated the hypothalamus paraventricular nucleus,arcuate nucleus,back inside of the nuclear;Intraoperative attention and protection of the adjacent nucleus,arcuate nucleus and dorsal medial nucleus may reduce hypothalamic complication and improve prognosis of craniopharyngeal tumor.Further study on the three nuclear groups will probably clarify the mechanism of hypothalamic complications. |
PDF Full Text Request