mr弥散张量成在颅内肿瘤中的应用.pdf

摘 要 MR 弥散张量成像在颅内肿瘤中的应用 研究生：王辉 导师：贾文霄 教授 摘 要 目的：研究 DTI 在不同颅内肿瘤中的应用，探讨 ADC 及 FA 在诊断和鉴别诊 断中的价值。方法：本研究共 39 例颅内肿瘤，胶质瘤 12 例、脑膜瘤 10 例、淋巴 瘤 8 例、神经鞘瘤 9 例，全部病例均经手术病理证实。建立彩色弥散张量图，在肿 瘤的实质区选择感兴趣区，测量得 ADC 值和 FA 值，分析二者在不同肿瘤之间的差 异。通过扩散张量纤维束示踪（DTT ）在肿瘤区和健侧对应部位重建主要白质纤维 束，并与肿瘤融合，观察纤维束的形态变化。结果：神经鞘 ADC 值最高，脑膜瘤 FA 值最高。神经鞘瘤的 ADC 值和 FA 值与脑膜瘤均具有显著性差异(P0.05) 。淋巴 瘤ADC 值最低，与胶质瘤有显著性差异(P0.05) ，两者FA 值无显著性差异（P0.05 ）。 肿瘤周围白质纤维束可见受压移位、浸润及破坏三种改变。术后，移位者可恢复， 浸润及破坏者无明显恢复。结论：不同颅内肿瘤的 ADC 和 FA 存在明显差异，DTT 可显示颅内肿瘤与白质结构的位置关系及术前术后白质纤维束形态改变。 关键词： 弥散张量成像；颅内肿瘤；磁共振 —1— 新疆医科大学医学硕士学位论文 APPLICABLE STUDY OF DTI IN BRAIN NEOPLASMS Postgraduate: Wang Hui Supervisor: Prof.Jia Wen-xiao Abstract Purpose: To evaluate the role of diffusion tensor imaging (DTI) in the differentiation of these cerebral tumors and to investigate the value of diagnosis with regard to apparent diffusion coefficient(ADC) and fractional anisotropy(FA). Methods: The study had 39 case of brain neoplasms, inclding 12 case of glioma, 10 case of meningioma, 8 case of lymphoma, 9 case of neurinoma. All case were confirmed by pathology after surgery. By reconstrusting color-tentor, we choose the solid area of tumors as region of interest (ROI) and measure ADC and FA of ROI. The differentiation of ADC and FA among the four types of tumors were analyzed. To reconstruct chief nerve fiber bundle which surrounding tumors by diffusion tensor tractography （DTT ）, mix together with tumors and observe the shape of fiber. Results: ADC of neurinoma is highest, and