脑外占位性病变对视放射影响的初步研究
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摘要
背景：视放射可以被脑内病变浸润或破坏，脑外占位病变是否损伤视放射情况研究较少。
目的：利用MR-DTI技术行三维脑白质纤维束成像，评价脑外病变对视放射的改变，探讨脑外占位效应对视放射改变与受损部位部分各向异性值(FA值)改变的量化对应关系。
方法：18例脑膜瘤术前患者及10例急性创伤性硬膜外血肿术后患者被纳入本研究。18例脑膜瘤患者术前行常规MRI及fMRI扫描，术前根据解剖图像，以BrainLAB及Dti Studio软件勾画病变范围、重建视放射，观测病变占位程度对视放射传导束可视化和受损程度，了解脑外占位性病变与视放射的位置关系及视放射受损程度情况。10例急性硬膜外血肿术后患者早期行常规MRI及fMRI扫描，同样利用MR-DTI技术行三维脑白质成像，重建视放射，观测脑外占位病变去除后，视放射传导束受损程度情况。
结果：彩色编码张量图、三维示踪图可清楚地显示目标视放射的位置，走行和受损状况。相应地将脑外占位病变致视放射的改变分为4种，把所有病例中患侧FA值与健侧FA值之比值从0~1等分为4个区间。视放射完全破坏者其比值位于第1区间，即小于25%；中度破坏病例其两者比值位于第2区间，即位于25%~50%；移位病例其两者比值位于第3区间，即位于50%~75%；基本正常或正常者位于第4区间，即其比值大于75%。18例脑膜瘤患者患侧与对侧FA值之比位于这4个区间情况为：视放射完全破坏者1例，视放射的患侧FA值与健侧FA值之比为10.0%；移位、中度破坏者3例，其患侧与健侧FA值之比分别为45.5%、40.1%与36.2%；轻度移位者11例，其患侧与健侧FA值之比为均值68.4%；正常或基本正常者3例，其患侧与健侧FA值之比均大于75%。10例急性硬膜外血肿术后患者的致视放射的改变结果为：完全破坏者2例；中度破坏者3例；轻度移位者4例；正常或基本正常者1例。
结论: MR-DTI技术可以对脑外占位性病变行视放射示踪，使其清晰地可视化，FA值的改变程度与视放射受损程度呈正相关。利用MR-DTI可以用于早期判断脑外占位性病变术后的视放射受损程度及预后。
Background: The optic radiation can be infiltrated or damaged in brain lesions。Little is known about optic radiation injury in patients with extracerebral lesions besidethe optic radiation.
Objective: Magnetic resonance diffusion tensor imaging can clearly detectextracerebral lesions beside the optic radiation. This study showed that alteredanisotropy values correspond with bilateral optic-radiation shape, size and location.
Methods: Totally18preoperative-Meningioma and10postoperative-EpiduralHematoma patients completed the whole experiment. Three-dimensional radioactivetracing and conventional magnetic resonance imaging of optic-radiation fiber bundles in18meningioma patients before surgery using iPlan2.6software. Optic radiationinvolving tissues observed by magnetic resonance-diffusion tensor imaging usingDTI-Studio software. Optic radiation involving tissues and postoperative-EpiduralHematoma patients in10postoperative-epidural hematoma patients observed bymagnetic resonance-diffusion tensor imaging using DTI-Studio software.
Results: The results of conventional MRI, FA, color-coded tensor maps andthree-dimensional white-matter tracing were compared.Patients were classified into fourintervals of the ratio of the FA value for the affected side to that for the healthy side.Patients in the first interval, having a ratio less than25%, had complete destruction ofthe optic radiation; patients in the second interval, having a ratio of25%–50%, hadmoderate damage; patients in the third interval, having a ratio of50%–75%, had ashifted optic radiation; and patients in the fourth interval, having a ratio greater than75%, had a normal or nearly normal optic radiation. In the group ofpreoperative-Meningioma patients, there was one case of complete destruction of theoptic radiation, with an FA value ratio of the affected side to the contralateral side of10.5%; three cases of shift and moderate destruction, with FA value ratios of46.3%, 40.5%and37.4%;11cases of slight shifting, with the FA value ratio having a mean of69.6%; and three normal or nearly normal cases, with an FA value ratio greater than75%.In the group of postoperative-Epidural Hematoma patients, there was2case ofcomplete destruction of the optic radiation; three cases of shift and moderate destruction;4cases of slight shifting; and one normal or nearly normal cases.
Conclusion: Employing magnetic resonance diffusion tensor imaging,three-dimensional white-matter imaging and conventional magnetic resonance imagingcan demonstrate the extracerebral lesions and compression on surrounding brain tissue.A color-coded tensor map and three-dimensional tracer diagram were applied to clearlydisplay the optic-radiation location, course and damage. Results show that the alteredanisotropy values of extracerebral lesions patients correspond with optic-radiation shape,size and position on both sides. Experimental findings indicate that the magneticresonance diffusion tensor imaging technique is a means of tracing and clearlyvisualizing the optic radiation.
目的：利用MR-DTI技术行三维脑白质纤维束成像，评价脑外病变对视放射的改变，探讨脑外占位效应对视放射改变与受损部位部分各向异性值(FA值)改变的量化对应关系。
方法：18例脑膜瘤术前患者及10例急性创伤性硬膜外血肿术后患者被纳入本研究。18例脑膜瘤患者术前行常规MRI及fMRI扫描，术前根据解剖图像，以BrainLAB及Dti Studio软件勾画病变范围、重建视放射，观测病变占位程度对视放射传导束可视化和受损程度，了解脑外占位性病变与视放射的位置关系及视放射受损程度情况。10例急性硬膜外血肿术后患者早期行常规MRI及fMRI扫描，同样利用MR-DTI技术行三维脑白质成像，重建视放射，观测脑外占位病变去除后，视放射传导束受损程度情况。
结果：彩色编码张量图、三维示踪图可清楚地显示目标视放射的位置，走行和受损状况。相应地将脑外占位病变致视放射的改变分为4种，把所有病例中患侧FA值与健侧FA值之比值从0~1等分为4个区间。视放射完全破坏者其比值位于第1区间，即小于25%；中度破坏病例其两者比值位于第2区间，即位于25%~50%；移位病例其两者比值位于第3区间，即位于50%~75%；基本正常或正常者位于第4区间，即其比值大于75%。18例脑膜瘤患者患侧与对侧FA值之比位于这4个区间情况为：视放射完全破坏者1例，视放射的患侧FA值与健侧FA值之比为10.0%；移位、中度破坏者3例，其患侧与健侧FA值之比分别为45.5%、40.1%与36.2%；轻度移位者11例，其患侧与健侧FA值之比为均值68.4%；正常或基本正常者3例，其患侧与健侧FA值之比均大于75%。10例急性硬膜外血肿术后患者的致视放射的改变结果为：完全破坏者2例；中度破坏者3例；轻度移位者4例；正常或基本正常者1例。
结论: MR-DTI技术可以对脑外占位性病变行视放射示踪，使其清晰地可视化，FA值的改变程度与视放射受损程度呈正相关。利用MR-DTI可以用于早期判断脑外占位性病变术后的视放射受损程度及预后。
Background: The optic radiation can be infiltrated or damaged in brain lesions。Little is known about optic radiation injury in patients with extracerebral lesions besidethe optic radiation.
Objective: Magnetic resonance diffusion tensor imaging can clearly detectextracerebral lesions beside the optic radiation. This study showed that alteredanisotropy values correspond with bilateral optic-radiation shape, size and location.
Methods: Totally18preoperative-Meningioma and10postoperative-EpiduralHematoma patients completed the whole experiment. Three-dimensional radioactivetracing and conventional magnetic resonance imaging of optic-radiation fiber bundles in18meningioma patients before surgery using iPlan2.6software. Optic radiationinvolving tissues observed by magnetic resonance-diffusion tensor imaging usingDTI-Studio software. Optic radiation involving tissues and postoperative-EpiduralHematoma patients in10postoperative-epidural hematoma patients observed bymagnetic resonance-diffusion tensor imaging using DTI-Studio software.
Results: The results of conventional MRI, FA, color-coded tensor maps andthree-dimensional white-matter tracing were compared.Patients were classified into fourintervals of the ratio of the FA value for the affected side to that for the healthy side.Patients in the first interval, having a ratio less than25%, had complete destruction ofthe optic radiation; patients in the second interval, having a ratio of25%–50%, hadmoderate damage; patients in the third interval, having a ratio of50%–75%, had ashifted optic radiation; and patients in the fourth interval, having a ratio greater than75%, had a normal or nearly normal optic radiation. In the group ofpreoperative-Meningioma patients, there was one case of complete destruction of theoptic radiation, with an FA value ratio of the affected side to the contralateral side of10.5%; three cases of shift and moderate destruction, with FA value ratios of46.3%, 40.5%and37.4%;11cases of slight shifting, with the FA value ratio having a mean of69.6%; and three normal or nearly normal cases, with an FA value ratio greater than75%.In the group of postoperative-Epidural Hematoma patients, there was2case ofcomplete destruction of the optic radiation; three cases of shift and moderate destruction;4cases of slight shifting; and one normal or nearly normal cases.
Conclusion: Employing magnetic resonance diffusion tensor imaging,three-dimensional white-matter imaging and conventional magnetic resonance imagingcan demonstrate the extracerebral lesions and compression on surrounding brain tissue.A color-coded tensor map and three-dimensional tracer diagram were applied to clearlydisplay the optic-radiation location, course and damage. Results show that the alteredanisotropy values of extracerebral lesions patients correspond with optic-radiation shape,size and position on both sides. Experimental findings indicate that the magneticresonance diffusion tensor imaging technique is a means of tracing and clearlyvisualizing the optic radiation.
引文
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