弥散张量联合荧光素钠指导功能区胶质瘤手术治疗价值.doc

弥散张量联合荧光素钠指导功能区胶质瘤手术治疗价值 张海旺1，张 苓1，陈礼刚1，彭里磊1，周 杰1，陆笑非2，酉 建1，刘洛同1，明 扬1 （646000 四川 泸州，泸州医学院附属医院:神经外科1，影像科2） [摘要] 目的 探讨术前弥散张量成像（diffusion tensor imaging，DTI)联合术中荧光素钠显像指导功能区胶质瘤手术治疗价值。方法 对2010年2月至2011年6月在我院采用DTI联合荧光素钠手术和传统手术治疗且获得随访月份≦24月的功能区胶质瘤患者的病历资料进行回顾性分析，DTI联合荧光素钠组21例术前均行增强MRI、DTI联合术中应用荧光素钠显像,传统组22例术前均行增强MRI。术后第1天均行增强MRI检查患者肿瘤切除程度、术后2周用Karnofsky评分评价患者生存质量、术后均行同步放化疗3个月以上，观察患者术后2年的生存率。结果 术后增强MRI示观察组在肿瘤的全切率上显著高于对照组，术后2周Karnofsky评分观察组显著高于对照组，观察组术后2年的生存率显著高于对照组，差异有统计学意义（P0.05）。结论 弥散张量成像联合荧光素钠显像技术能确保术中最小程度破坏功能纤维束而最大程度切除肿瘤，提高患者生存质量和生存时间。 [关键词] 胶质瘤；荧光素钠；弥散张量成像 [中图法分类号] R605；R739.41 [文献标志码] A Clinic value of diffusion tensor imaging and fluorescein sodium in operation of gliomas in or near the eloquent region Zhang Haiwang, Zhang Ling,Chen Ligang,Peng Lilei, Zhou Jie,You Jian, Liu Luotong,Ming Yang(Department of Neurosurgery, The Affiliated Hospital of Luzhou Medical College, Luzhou, 646000,Lu Xiaofei Department of Radiology, The Affiliated Hospital of Luzhou Medical College, Luzhou, 646000) [Abstract] Objective To investigate the value of diffusion tensor imaging and fluorescein sodium in resection of gliomas in or near the eloquent region. Methods To retrospectively investigate patients with gliomas in or near the eloquent region in our hospital from February 2010 to June 2011.These patients were followed up less than 24months and divided into 2 groups DTI combinated with control group and observation group. 21 patients in observation group were underwent enhanced MRI, DTI before operation and were injected fluorescein sodium during operation. 22 patients in control group were underwent enhanced MRI before operation. All patients were underwent enhanced MRI to assess the degree of resection 1 day after the operation; Karnofsky score was used to evaluate patients qulity of life 2 weeks after the operation; All patients were underwent chemoradiotherapy after operation for more than 3 months. Two-year survival rate of patients was observed. Results Tot