*Department of Neurosurgery, the First Affiliated Hospital of China Medical University, Liaoning, People's Republic of China; ‡Department of Radiology, the First Affiliated Hospital of China Medical University, Liaoning, People's Republic of China; and §Department of Psychiatry, the First Affiliated Hospital of China Medical University, Liaoning, People's Republic of China.
Neurosurgery. 2013 Dec;73(6):1044-53; discussion 1053. doi: 10.1227/NEU.0000000000000146.
Diffusion tensor imaging (DTI) tractography enables the in vivo visualization of white matter tracts inside normal brain tissue, which provides the neurosurgeon important information to plan tumor resections. However, DTI is associated with restrictions in the resolution of crossing fibers in the vicinity of the tumor or in edema. We find that generalized q-sampling imaging (GQI) can overcome these difficulties and is advantageous over DTI for the tractography of the fiber bundle in peritumoral edema.
To demonstrate the differences between GQI and DTI in the preoperative mapping of fiber tractography in peritumoral edema of cerebral tumors, and discuss the clinical application of GQI in neurosurgical planning.
Five patients with brain tumors underwent 3-T magnetic resonance imaging scans, and the data were reconstructed by DTI and GQI. We adjusted the parameters and compared the differences between DTI and GQI in visualizing the fiber tracts in the peritumoral edema of cerebral tumors.
GQI and DTI showed substantial differences in displaying the nerve fibers in the edema surrounding the tumor. The GQI tractography method could fully display existing intact fibers in the edema, whereas the fiber tracts in edema displayed by DTI tractography were incomplete, missing, or ruptured.
GQI can visualize the tracts in the peritumoral edema of cerebral tumors better than DTI. Although GQI has many limitations, its future in the preoperative guidance of brain tumor lesions is promising.
弥散张量成像(DTI)纤维束示踪技术能够在正常脑组织内可视化白质束,为神经外科医生提供了在肿瘤切除术前计划的重要信息。然而,DTI 存在在肿瘤附近或水肿处交叉纤维分辨率受限的问题。我们发现广义 q 采样成像(GQI)可以克服这些困难,并且在肿瘤周围水肿的纤维束示踪方面优于 DTI。
在脑肿瘤周围水肿的术前纤维束示踪图中,比较 GQI 和 DTI 的差异,并讨论 GQI 在神经外科手术规划中的临床应用。
5 例脑肿瘤患者接受 3-T 磁共振成像扫描,数据由 DTI 和 GQI 重建。我们调整参数并比较 DTI 和 GQI 在显示脑肿瘤周围水肿中纤维束的差异。
GQI 和 DTI 在显示肿瘤周围水肿中神经纤维方面存在显著差异。GQI 示踪方法可以充分显示水肿中存在的完整纤维,而 DTI 示踪的纤维束在水肿中显示不完整、缺失或断裂。
GQI 比 DTI 更能可视化脑肿瘤周围水肿中的纤维束。虽然 GQI 存在许多局限性,但它在脑肿瘤病变的术前指导中具有广阔的前景。