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经胼胝体间穹窿入路切除后穹窿和海马相关脑区的功能改变的 rs-fMRI 研究。

The rs-fMRI study of effects of fornix and hippocampus-related brain function after the transcallosal interforniceal approach.

机构信息

Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing, China.

Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Brain Res Bull. 2019 Aug;150:207-215. doi: 10.1016/j.brainresbull.2019.05.014. Epub 2019 May 22.

Abstract

BACKGROUND

The tumors in third ventricle are common intracranial tumors in children, characterized by various pathological types and difficult to be removed. The transcallosal interforniceal approach is often used for these tumors. The separation of bilateral fornix causes multiple surgical complications. In the past, complications could only be assessed by clinical feature and traditional imaging, lack of quantitative data to support. Resting-state functional magnetic resonance imaging (rs-fMRI) can assess brain functional connectivity between local regions and different regions in quiet state. The changes of ReHo, ALFF, fALFF and brain function connections (DMN and Hippocampus as ROI) can be used to evaluate the effects caused by operation.

OBJECTIVE

To evaluate the effects of brain function caused by operation.

METHODS

9 children patients with tumors in third ventricle were randomly selected in Yuquan hospital, and scanned by rs-fMRI before and after operation. ReHo, ALFF, fALFF and function connections (DMN and Hippocampus as ROI) were chosen to analyze rs-fMRI data.

RESULTS

The results of ReHo, ALFF, fALFF and brain function connections (DMN and Hippocampus as ROI) showed that: (1) Compared with preoperative state, ReHo decreased in left superior frontal gyrus in 1 month after operation, while increased in right middle occipital gyrus, right middle temporal gyrus, and left posterior central gyrus. In 2 months after operation, ReHo decreased in left superior temporal gyrus and right precentral gyrus compared with that in 1 month after operation. (2) Compared with preoperative state, ALFF decreased in left middle frontal gyrus and increased in left superior temporal gyrus in 1 month after operation; ALFF decreased in right fusiform gyrus and right supramarginal gyrus, while increased in left parahippocampal gyrus and left caudate nucleus in 2 months after operation. When compared with these in 1 month after operation, ALFF decreased in right fusiform gyrus and left precentral gyrus in 2 months after operation. (3) Compared with preoperative state, fALFF decreased in left superior frontal gyrus in 1 month after operation, and decreased in left middle frontal gyrus in 2 months after surgery. (4) The connections of DMN showed that enhanced connections of bilateral middle frontal gyrus and other regions in 1 month after operation, which restored to preoperative state in 3 months after operation. (5) There were changes of connections between bilateral hippocampus and related brain regions without any interruption occurred. The effects of approach can disappear in 3 months after operation.

CONCLUSIONS

The short-term effects of ReHo, ALFF and fALFF in brain regions of children patients can recover to preoperative state with time. The operation did not interrupt the connections between DMN and hippocampus related brain areas. The effects of surgery can restore to the preoperative state in 3 months after operation.

摘要

背景

第三脑室肿瘤是儿童常见的颅内肿瘤,具有多种病理类型,难以切除。经胼胝体-穹窿间入路常用于这些肿瘤。双侧穹窿的分离会导致多种手术并发症。过去,并发症只能通过临床特征和传统影像学评估,缺乏定量数据支持。静息态功能磁共振成像(rs-fMRI)可在安静状态下评估局部区域和不同区域之间的脑功能连接。ReHo、ALFF、fALFF 和脑功能连接(以 DMN 和海马体为 ROI)的变化可用于评估手术引起的影响。

目的

评估手术引起的脑功能变化。

方法

随机选择 9 例第三脑室肿瘤患儿于我院行手术治疗,术前及术后均行 rs-fMRI 扫描。选择 ReHo、ALFF、fALFF 和脑功能连接(以 DMN 和海马体为 ROI)进行 rs-fMRI 数据分析。

结果

ReHo、ALFF、fALFF 和脑功能连接(以 DMN 和海马体为 ROI)的结果显示:(1)与术前状态相比,术后 1 个月左侧额上回 ReHo 降低,右侧中枕叶、右侧中颞叶和左侧后中央回 ReHo 升高;术后 2 个月,与术后 1 个月相比,左侧颞上回和右侧中央前回 ReHo 降低。(2)与术前状态相比,术后 1 个月左侧额中回 ALFF 降低,左侧颞上回 ALFF 升高;术后 2 个月右侧梭状回和右侧缘上回 ALFF 降低,左侧海马旁回和左侧尾状核 ALFF 升高;与术后 1 个月相比,术后 2 个月右侧梭状回和左侧中央前回 ALFF 降低。(3)与术前状态相比,术后 1 个月左侧额上回 fALFF 降低,术后 2 个月左侧额中回 fALFF 降低。(4)DMN 的连接显示,术后 1 个月双侧额中回和其他区域的连接增强,术后 3 个月恢复术前状态。(5)双侧海马体与相关脑区的连接发生变化,但无中断。手术的影响可以在术后 3 个月恢复到术前状态。

结论

儿童患者脑区 ReHo、ALFF 和 fALFF 的短期影响可随时间恢复到术前状态。手术并未中断与 DMN 和海马体相关脑区的连接。术后 3 个月,手术的影响可恢复到术前状态。

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