本文選題：腦腫瘤　切入點(diǎn)：視功能　出處：《重慶醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的 采用靜息態(tài)功能磁共振成像（RS-fMRI）和獨(dú)立成分分析（ICA）方法對(duì)正常人以及枕部腦腫瘤術(shù)前患者進(jìn)行視中樞功能空間定位，評(píng)價(jià)其在枕部病變治療計(jì)劃制定以及預(yù)后評(píng)估中的價(jià)值。 方法 采集在年齡、性別和左右利手上與患者組相匹配的19例志愿者（正常對(duì)照組）及8例枕部腦腫瘤患者（患者組）術(shù)前RS-fMRI數(shù)據(jù)和臨床視野檢查資料，利用ICA方法提取所有受試者的Brodmann17區(qū)及18區(qū)視中樞網(wǎng)絡(luò)。由兩位高年資神經(jīng)影像醫(yī)師觀察記錄正常對(duì)照組的視中樞網(wǎng)絡(luò)表現(xiàn)，然后在不知道臨床視野檢查結(jié)果的情況下，觀測(cè)視中樞網(wǎng)絡(luò)完整性和分布情況，并與臨床視野檢查結(jié)果進(jìn)行比較。 結(jié)果 RS-fMRI顯示正常對(duì)照組雙側(cè)視覺皮層Brodmann17區(qū)及18區(qū)視中樞網(wǎng)絡(luò)完整存在；患者組Brodmann17及18區(qū)的視中樞網(wǎng)絡(luò)連接強(qiáng)度和范圍與正常對(duì)照組及健側(cè)比較有不同程度降低，視中樞功能區(qū)明顯受壓移位者5例，視中樞完整性受損者6例，鄰近腦區(qū)視覺網(wǎng)絡(luò)連接增強(qiáng)者6例，腫瘤周圍視中樞網(wǎng)絡(luò)連接增強(qiáng)者4例。術(shù)前視野檢查存在視野缺損的2例患者均顯示視中樞網(wǎng)絡(luò)完整性受損，鄰近腦區(qū)視覺功能代償，腫瘤周圍視中樞未見代償；視野正常的6例中有2例視中樞網(wǎng)絡(luò)完整性基本存在，其余4例視中樞網(wǎng)絡(luò)完整性受損，，腫瘤周圍及鄰近腦區(qū)視覺功能可見代償。 結(jié)論 RS-fMRI檢查可滿意地獲取正常人腦的靜息態(tài)視中樞網(wǎng)絡(luò)分布，可幫助判斷枕部腦腫瘤患者視中樞網(wǎng)絡(luò)完整性，其表現(xiàn)與傳統(tǒng)臨床視野檢查結(jié)果有較好一致性，并且此方法更具客觀性，患者依從性也更好。枕部腦腫瘤患者視中樞可能發(fā)生受壓移位、完整性受損或存在代償功能區(qū)，應(yīng)用RS-fMRI方法對(duì)其進(jìn)行準(zhǔn)確定位，可幫助臨床制定手術(shù)或放療計(jì)劃并評(píng)估患者視覺預(yù)后。
[Abstract]:Purpose. Resting functional magnetic resonance imaging (RS-f MRI) and independent component analysis (ICA) were used to locate the visual function of normal subjects and patients with occipital brain tumors before operation, and to evaluate its value in the treatment plan and prognosis of occipital lesions. Method. RS-fMRI data and clinical visual field examination data were collected from 19 volunteers (normal control group) and 8 patients with occipital brain tumor (patient group) matched with patients with age, sex and left and right hands. ICA method was used to extract the visual central network of all the subjects in the Brodmann17 and 18 regions. Two senior neuroimaging physicians observed and recorded the manifestations of the visual central network in the normal control group, and then did not know the results of the clinical visual field examination. The integrity and distribution of visual central network were observed and compared with the results of clinical visual field examination. Results. RS-fMRI showed that the visual central network of bilateral visual cortex Brodmann17 and 18 was intact in normal control group, and the intensity and range of optic central network connection in Brodmann17 and 18 regions in the patient group were lower than those in the normal control group and healthy side. There were 5 cases with obvious compression displacement of the visual central functional area, 6 cases with impaired visual central integrity and 6 cases with enhanced visual network connection in the adjacent brain area. All the 2 patients with visual field defect showed that the integrity of the visual center network was impaired, the visual function was compensated in the adjacent brain area, and no compensation was found in the surrounding visual center of the tumor. Of the 6 cases with normal visual field, 2 cases had the integrity of the visual central network, while the other 4 cases had impaired visual central network integrity, and the visual function around the tumor and adjacent brain area could be compensated. Conclusion. RS-fMRI can obtain the distribution of resting visual center network in normal human brain satisfactorily, and can help to judge the integrity of optic central network in patients with occipital brain tumor. The results of RS-fMRI are in good agreement with the results of traditional clinical visual field examination. And this method is more objective and patient compliance is better. Occipital brain tumor patients with visual center may be under pressure displacement, integrity damage or the existence of compensatory functional areas, the use of RS-fMRI method to accurately locate it. It can help to make surgery or radiotherapy plan and evaluate the visual prognosis of patients.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R739.41;R445.2

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