多频带弥散张量成像在脑肿瘤患者术前运动和语言通路定位中的应用。
Multiband diffusion tensor imaging for presurgical mapping of motor and language pathways in patients with brain tumors.
机构信息
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Brain Tumor Center, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
出版信息
J Neuroimaging. 2021 Jul;31(4):784-795. doi: 10.1111/jon.12859. Epub 2021 Apr 5.
BACKGROUND AND PURPOSE
Assessment of the essential white matter fibers of arcuate fasciculus and corticospinal tract (CST), required for preoperative planning in brain tumor patients, relies on the reliability of diffusion tensor imaging (DTI). The recent development of multiband DTI (mb-DTI) based on simultaneous multislice excitation could maintain the overall quality of tractography while not exceeding standard clinical care time. To address this potential, we performed quantitative analyses to evaluate tractography results of arcuate fasciculus and CST acquired by mb-DTI in brain tumor patients.
METHODS
We retrospectively analyzed 44 patients with brain lesions who underwent presurgical single-shot DTI (s-DTI) and mb-DTI. We measured DTI parameters: fractional anisotropy (FA) and mean diffusivity (MD [mm s ]) in whole brain and tumor regions; and the tractography parameters: fiber FA, MD (mm s ), volume (mm ), and length (mm) in the whole brain, arcuate fasciculus, and CST. Additionally, three neuroradiologists performed a blinded visual assessment comparing s-DTI with mb-DTI.
RESULTS
The mb-DTI showed higher mean FA and lower MD (r > .95, p < .002) in whole brain and tumor regions of interest; slightly higher fiber FA, volume, and length; and slightly lower fiber MD in whole brain, arcuate fasciculus, and CST than in s-DTI. These differences were significant for fiber FA in all tracts; length (mm) in arcuate fasciculus; and fiber MD (mm s ) and volume (mm ) in all patients with tumor involved in the arcuate fasciculus, CST, and whole brain tracts (p = .001). Visual assessment demonstrated that both techniques produced visually similar tracts.
CONCLUSIONS
This study demonstrated the clinical potential and significant advantages of preoperative mb-DTI in brain tumor patients.
背景与目的
评估脑肿瘤患者术前规划所需的弓状束和皮质脊髓束（CST）的基本白质纤维，依赖于弥散张量成像（DTI）的可靠性。基于同时多层激发的多频带 DTI（mb-DTI）的最新发展可以在不超过标准临床护理时间的情况下保持轨迹的整体质量。为了解决这个问题，我们进行了定量分析，以评估脑肿瘤患者通过 mb-DTI 获得的弓状束和 CST 的轨迹结果。
方法
我们回顾性分析了 44 例接受术前单次激发 DTI（s-DTI）和 mb-DTI 的脑病变患者。我们测量了全脑和肿瘤区域的 DTI 参数：各向异性分数（FA）和平均弥散度（MD[mm s]）；以及全脑、弓状束和 CST 的轨迹参数：纤维 FA、MD（mm s）、体积（mm）和长度（mm）。此外，三位神经放射科医生对 s-DTI 与 mb-DTI 进行了盲法视觉评估。
结果
mb-DTI 在全脑和肿瘤感兴趣区显示出更高的平均 FA 和更低的 MD（r>.95，p<.002）；略高的纤维 FA、体积和长度；以及略低的全脑、弓状束和 CST 纤维 MD。这些差异在所有束纤维 FA 中均有统计学意义；在所有涉及弓状束、CST 和全脑束的肿瘤患者中，在弓状束中的长度（mm）；以及纤维 MD（mm s）和体积（mm）（p =.001）。视觉评估表明，这两种技术都产生了视觉上相似的束。
结论
本研究表明术前 mb-DTI 在脑肿瘤患者中具有临床潜力和显著优势。
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