Zhang Yan, Wan Si-Hai, Wu Gui-Jun, Zhang Xue-Lin
Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.
Int J Ophthalmol. 2012;5(4):452-8. doi: 10.3980/j.issn.2222-3959.2012.04.09. Epub 2012 Aug 18.
To investigate the visual pathway in normal subjects and patients with lesion involved by diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT).
Thirty normal volunteers, 3 subjects with orbital tumors involved the optic nerve (ON) and 33 subjects with occipital lobe tumors involved the optic radiation (OR) (10 gliomas, 6 meningiomas and 17 cerebral metastases) undertook routine cranium magnetic resonance imaging (MRI), DTI and DTT. Visual pathway fibers were analyzed by DTI and DTT images. Test fractional anisotropy (FA) and mean diffusivity (MD) values in different part of the visual pathway.
The whole visual pathway but optic chiasm manifested as hyperintensity in FA maps and homogenous green signal in the direction encoded color maps. The optic chiasm did not display clearly. There was no significant difference between the bilateral FA values and MD values of normal visual pathway but optic chiasm, which the FA values tested were much too low (all P>0.05). The ONs of subjects with orbital tumors were compressed and displaced. Only one subject had lower FA values and higher MD values. OR of 9 gliomas subjects were infiltrated, with displacement in 2 and disruption in 7 subjects. All OR in 6 meniongiomas subjects were displaced. OR in 17 cerebral metastases subjects all developed displacement while 7 of them had disruption also.
MR-DTI is highly sensitive in manifesting visual pathway. Visual pathway can be analyzed quantitatively in FA and MD values. DTT supplies accurate three dimensional conformations of visual pathway. But optic chiasm's manifestation still needs to improve.
通过扩散张量成像(DTI)和扩散张量纤维束成像(DTT)研究正常受试者及病变患者的视觉通路。
30名正常志愿者、3名累及视神经(ON)的眼眶肿瘤患者和33名累及视辐射(OR)的枕叶肿瘤患者(10例胶质瘤、6例脑膜瘤和17例脑转移瘤)接受常规头颅磁共振成像(MRI)、DTI和DTT检查。通过DTI和DTT图像分析视觉通路纤维。检测视觉通路不同部位的分数各向异性(FA)和平均扩散率(MD)值。
除视交叉外,整个视觉通路在FA图上表现为高信号,在方向编码彩色图上表现为均匀的绿色信号。视交叉显示不清晰。正常视觉通路除视交叉外,双侧FA值和MD值无显著差异,所测FA值过低(均P>0.05)。眼眶肿瘤患者的视神经受压移位。仅1例患者FA值较低,MD值较高。9例胶质瘤患者的视辐射受浸润,2例移位,7例中断。6例脑膜瘤患者的视辐射均移位。17例脑转移瘤患者的视辐射均发生移位,其中7例中断。
MR-DTI在显示视觉通路上具有高度敏感性。可通过FA和MD值对视觉通路进行定量分析。DTT提供了视觉通路准确的三维结构。但视交叉的显示仍需改进。