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临床诊断并经病理证实的颈段脊髓星形细胞瘤的轴向磁共振扩散张量成像及纤维束成像

Axial MR diffusion tensor imaging and tractography in clinical diagnosed and pathology confirmed cervical spinal cord astrocytoma.

作者信息

Zhao Mangsuo, Shi Bingxin, Chen Tuoyu, Zhang Yuqi, Geng Tongchao, Qiao Liyan, Zhang Mingjie, He Le, Zuo Huancong, Wang Guihuai

机构信息

Department of Neurology, Yuquan Hospital, Clinical Neuroscience Institute, Medical Center, Tsinghua University, Beijing 100040, PR China.

Department of Neurosurgery, Yuquan Hospital, Clinical Neuroscience Institute, Medical Center, Tsinghua University, Beijing 100040, PR China.

出版信息

J Neurol Sci. 2017 Apr 15;375:43-51. doi: 10.1016/j.jns.2017.01.044. Epub 2017 Jan 14.

Abstract

OBJECTIVE

To evaluate the diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) features of cervical spinal cord astrocytoma.

METHODS

Eleven patients with cervical spinal cord astrocytomas and 10 healthy volunteers were recruited in this study. Conventional magnetic resonance imaging (MRI) and axial DTI were performed on a 3.0T MRI system. Apparent diffusion coefficient (ADC), fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD) values for the lesions were measured. DTT was performed using the principal diffusion direction method.

RESULTS

ADC values of the lesions and the normal-appearing tissue around the tumour (NATAT) on T2-weighted imaging (T2WI) increased. The ADC values of the lesions were higher. The FA values of the lesions and the NATAT decreased significantly, with the lesions having lower FA values. The RD value (1.36±0.49) of the tumours was significantly higher than those found in the healthy controls, but similar for the AD value (1.84±0.56). There were no differences in ADC or FA values between lesions and NATAT in McCormick Type I vs. Type II patients. Based on the DTT, 7 patients with solid mass tumours were classified as Type I. One patient with a solid mass, 2 patients with cystic degeneration inside the lesions, and 1 patient with a cyst around the mass were classified as Type II.

CONCLUSIONS

FA values of the cervical spinal cord astrocytoma decreased, but the ADC values increased. DTI was sensitive for the evaluation of pathological changes that could not be visualized on T2WI. Our preliminary study indicates that DTT can be used to guide operation planning, and that axial images of DTT may be more valuable.

摘要

目的

评估颈段脊髓星形细胞瘤的扩散张量成像(DTI)和扩散张量纤维束成像(DTT)特征。

方法

本研究纳入了11例颈段脊髓星形细胞瘤患者和10名健康志愿者。在3.0T磁共振成像(MRI)系统上进行常规MRI和轴位DTI检查。测量病变的表观扩散系数(ADC)、各向异性分数(FA)、轴向扩散率(AD)和径向扩散率(RD)值。使用主扩散方向法进行DTT。

结果

病变及肿瘤周围正常表现组织(NATAT)在T2加权成像(T2WI)上的ADC值升高。病变的ADC值更高。病变及NATAT的FA值显著降低,病变的FA值更低。肿瘤的RD值(1.36±0.49)显著高于健康对照组,但AD值(1.84±0.56)相似。McCormick I型与II型患者的病变与NATAT之间的ADC或FA值无差异。基于DTT,7例实性肿块肿瘤患者被分类为I型。1例实性肿块患者、2例病变内有囊性变的患者和1例肿块周围有囊肿的患者被分类为II型。

结论

颈段脊髓星形细胞瘤的FA值降低,但ADC值升高。DTI对评估T2WI上不可见的病理变化敏感。我们的初步研究表明,DTT可用于指导手术规划,且DTT的轴位图像可能更有价值。

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