Matsuura Chie, Sakaeyama Yuki, Abe Mitsuyoshi, Mikai Masataka, Kubota Shuhei, Fuchinoue Yutaka, Terazono Sayaka, Kondo Kosuke, Harada Naoyuki, Sugo Nobuo
Department of Neurosurgery (Omori), Toho University Graduate School of Medicine, Tokyo, JPN.
Department of Neurosurgery (Omori), Faculty of Medicine, Toho University, Tokyo, JPN.
Cureus. 2024 Jul 22;16(7):e65099. doi: 10.7759/cureus.65099. eCollection 2024 Jul.
To determine whether diffusion tensor image (DTI) parameters and regional cerebral blood flow (rCBF) serve to preoperatively predict postoperative motor outcomes in patients with brain tumors.
We included 81 patients with brain tumors who underwent surgical treatment. Motor function was assessed using the manual muscle test in the upper and lower limbs at admission and discharge. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and their ratios (rFA, rMD, rAD, and rRD) were measured at the corona radiata, internal capsule, and cerebral peduncle of the corticospinal tract (CST). In addition, DTI and single photon emission computed tomography (SPECT) were synthesized to measure rCBF at the CST.
Both DTI parameters and rCBF at the CST in the preoperative motor weakness group significantly differed from those of the preoperative normal function group. rFA at the cerebral peduncle and the internal capsule was considerably higher in those showing postoperative motor recovery than in those postoperative unchanged or with deteriorated motor function (P < 0.05). Moreover, there was significantly lower rMD and rRD at the internal capsule in the motor recovery group (P < 0.05, P < 0.01). Furthermore, rCBF was higher at all the cerebral peduncle, internal capsule, and corona radiate in the motor recovery group than in the unchanged and deteriorated motor function group (P < 0.05, P < 0.01, P < 0.01).
The analysis of DTI parameters and rCBF is useful in predicting postoperative motor outcomes in patients with brain tumors.
确定弥散张量成像（DTI）参数和局部脑血流量（rCBF）是否有助于术前预测脑肿瘤患者的术后运动结局。
我们纳入了81例行手术治疗的脑肿瘤患者。在入院和出院时，使用上肢和下肢徒手肌力测试评估运动功能。在皮质脊髓束（CST）的放射冠、内囊和脑桥测量分数各向异性（FA）、平均扩散率（MD）、轴向扩散率（AD）、径向扩散率（RD）及其比值（rFA、rMD、rAD和rRD）。此外，将DTI与单光子发射计算机断层扫描（SPECT）合成，以测量CST处的rCBF。
术前运动无力组CST的DTI参数和rCBF均与术前功能正常组有显著差异。术后运动恢复者脑桥和内囊的rFA明显高于术后运动功能未改变或恶化者（P<0.05）。此外，运动恢复组内囊的rMD和rRD显著更低（P<0.05，P<0.01）。此外，运动恢复组脑桥、内囊和放射冠处的rCBF均高于运动功能未改变和恶化组（P<0.05，P<0.01，P<0.01）。
DTI参数和rCBF分析有助于预测脑肿瘤患者的术后运动结局。
