Neuroprotective Effect Of DTI Conduction Tract Reconstruction On High-grade Gliomas In Functional Area

Objective: To discuss the guidance and function protection of DTI conduction beam reconstruction in the resection of high-grade glioma in functional areas.Methods: Fiftyone patients with high-grade glioma who were admitted to the same medical group of Neurosurgery Department of Xinjiang Medical University from November 2018 to November 2020 were retrospectively enrolled and divided into DTI group and control group according to whether or not they had received preoperative DTI.In the DTI group,the tumor was removed preoperatively according to conventional MRI plain scan + enhancement+DTI.In the control group,the tumor was removed in the traditional way according to conventional MRI scanning + enhancement.Postoperative complications,degree of resection,length of hospital stay and KPS score at the fourth week after surgery were compared between the two groups.Tumor and peripheral nerve fiber bundles were divided into three types: extrusion type,invasion type and destruction type.The preoperative and postoperative neurological function,total resection rate and postoperative hospital stay were compared respectively.Result: Compared with the control group,the postoperative complications related to nerve fiber bundles in the DTI group were significantly different(11.54% vs 36%,P=0.039)and the length of hospital stay(15.35±2.62 vs18.63±4.34,P=0.001).Meanwhile,the KPS score in the DTI group at the 4th week after surgery was significantly improved(P=0.033).There was no significant difference in the course of resection(80.77% vs 84%,P=0.762)and general postoperative complications(19.23% vs 24%,P=0.679)between the two groups(P>0.05).The length of stay in the three types of DTI patients was not the same(P=0.019),and there was no difference in preoperative and postoperative neurological function and total resection rate(P>0.05).Conclusion: The application of DTI conduction bundle reconstruction technique in patients with high-grade glioma can completely remove the tumor as much as possible on the premise of protecting the fiber conduction tract,reduce the operative complications and hospitalization time related to the nerve fiber bundle,improve the prognosis of the patients,reduce the postoperative disability rate,and improve the postoperative quality of life of the patients.