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磁共振弥散张量示踪用于颈椎管内肿瘤的形态学研究
魏梁锋,王守森*,郑兆聪,薛亮,田君,应建彬
0
(第二军医大学福州临床医学院(南京军区福州总医院)神经外科, 福州 350025
*通信作者)
摘要:
目的 探讨颈椎管内肿瘤患者颈髓弥散张量纤维束示踪(DTT)的影像特点及其与脊髓功能、预后的关系。 方法 选取2014年2月至2015年1月在南京军区福州总医院经手术切除的颈椎管内肿瘤24例,在术前3 d及术后1个月行颈髓弥散张量成像(DTI)扫描,并通过DTT重建白质纤维束,观察纤维束走行及完整性情况。采用McCormick分级法进行脊髓功能的评估。 结果 DTT可清晰显现纤维束的饱满或稀疏情况、完整或中断现象,也可以观察纤维束与肿瘤之间的空间位置关系,如纤维束是受肿瘤推压移位还是包绕肿瘤。术前纤维束形态与McCormick分级及预后有关系,纤维束形态完整的患者术前脊髓功能状态及术后1个月时的预后均优于中断型(P<0.05)。 结论 DTT能直观显示白质纤维束的形态,并对颈椎管内肿瘤的预后判断具有参考价值。
关键词:  磁共振成像  弥散张量成像  弥散张量纤维束示踪  颈椎管内肿瘤  McCormick分级  预后
DOI:10.3724/SP.J.1008.2015.1187
投稿时间:2015-06-24修订日期:2015-09-16
基金项目:
Magnetic resonance diffusion tensor tracking technique for morphological study of cervical intraspinal tumors
WEI Liang-feng,WANG Shou-sen*,ZHENG Zhao-cong,XUE Liang,TIAN Jun,YING Jian-bin
(Department of Neurosurgery, Fuzhou General Hospital, PLA Nanjing Military Area Command, Fuzhou Clinical Medicine School of Second Military Medical University, Fuzhou 350025, Fujian, China
*Corresponding author.)
Abstract:
Objective To investigate the diffusion tensor tracking (DTT) imaging character of patients with cervical intraspinal tumors, and to study its association with spinal cord function and prognosis. Methods A total of 24 cervical intraspinal tumors were surgically removed from Feb. 2014 to Jan. 2015. Cervical diffusion tensor imaging (DTI) scan was performed in all patients three days preoperatively and one month postoperatively. The white matter fiber bundle was reconstructed by DTT to observe its traveling routes and integrity, and the spinal cord function was assessed by McCormick grading. Results DTT was able to distinctly display whether the tractography of white matter fiber bundle was full or sparse, intact or interrupted. The technique could also display the spacial relationship(displacement or encasement) between the tumor and fiber bundle. The preoperative tractography was found to be correlated with McCormick grading and prognosis of spinal cord function. Preoperative spinal cord function and prognosis one month postoperatively were significantly better in patients with intact fiber bundle than those with interrupted one (P<0.05). Conclusion DTT can directly display the morphology of white matter fiber bundle, and may also help to predict the prognosis of cervical intraspinal tumors.
Key words:  magnetic resonance imaging  diffusion tensor imaging  diffusion tensor tracking  cervical intraspinal neoplasms  McCormick grading  prognosis