The role of diffusion tensor tractography in the surgical treatment of pediatric optic chiasmatic gliomas

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• 作者：Ming Ge (1)
  ShaoWu Li (1)
  Liang Wang (1)
  ChunDe Li (1)
  Junting Zhang (1)
  
  1. Department of Neurosurgery ; Beijing Tiantan Hospital ; Capital Medical University ; Tiantan Xili 6 ; Dongcheng District ; Beijing ; 100050 ; People鈥檚 Republic of China
  
• 关键词：Diffusion tensor tractography ; Optic chiasmatic gliomas ; Oncology ; Visual outcome
• 刊名：Journal of Neuro-Oncology
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：122
• 期：2
• 页码：357-366
• 全文大小：1,531 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Oncology
  
• 出版者：Springer Netherlands
• ISSN：1573-7373

文摘

Diffusion tensor tractography(DTT) can theoretically be used in assessing the optic chiasmatic glioma(OCGs),which are still in debate about optimal treatment. The purpose of this study was to investigate the role of this technology in offering more information about the tumor, assisting the debulking surgery, and helping to anticipate visual outcomes. As a prospective cohort study, the enrolled patients received routine pre- and postoperative neuro-ophthalmology, neuroimaging, and endocrine examinations. Fiber tractography was meanwhile performed based on diffusion tensor imaging examination. Identification of the position relationship between the lesions and residual optic path, and morphology analysis of them was done based on their DTT features. All the information was used for confirmation by the intraoperative findings. 11 pediatric patients were enrolled in this study. Most of them got subtotal resection of the tumors and stable postoperative visual outcomes. On the DTT imagings, the tumors were divided into infiltrative endophytic ones (TypeI) and inflated ones (TypeII), which can be subclassified as inferior and superior chiasmatic ones based on the positional relationships between the optic chiasm fibers and the tumors. These positional relationships were confirmed intraoperatively. The postoperative DTT images were quite different from preoperative ones. The application of DTT to children with OCGs is feasible, and valuable for getting more information about the disease, improving surgical techniques, and helping predict the overall and visual prognosis of the patients. The exact correlations of DTT features and visual outcomes need to be further verified.