【摘要】：目的:探討髓內(nèi)腫瘤的彌散張量成像(DTI)對(duì)脊髓髓內(nèi)腫瘤的診斷與治療的意義。方法:對(duì)7名頸髓髓內(nèi)腫瘤患者進(jìn)行影像學(xué)檢查,項(xiàng)目包括脊髓常規(guī)MR掃描、3D掃描及脊髓DTI,根據(jù)需要進(jìn)行纖維束示蹤(DTT)重建。儀器設(shè)備為3.0T MRTRIOTIM掃描儀(Siemens公司),采用NUMARIS/4軟件syngo MRB15版本后處理工作站進(jìn)行后處理,計(jì)算病變?nèi)ヅc相對(duì)正常頸髓平均擴(kuò)散系數(shù)(Average Diffusion Coefficient ADC)值,部分各向異性(Fractional Anisotropy FA)值。并結(jié)合檢查結(jié)果制定診療計(jì)劃,對(duì)效果進(jìn)行臨床觀察。觀察手術(shù)患者術(shù)后恢復(fù)狀況,探討其對(duì)髓內(nèi)腫瘤的診斷價(jià)值。結(jié)果:1名患者進(jìn)行手術(shù)治療,治療效果滿意,術(shù)中病變定位與DTI結(jié)果一致。其余患者在醫(yī)生明確交代手術(shù)風(fēng)險(xiǎn)后決定暫不手術(shù),將對(duì)其定期隨訪。結(jié)論:(1)DTI成像技術(shù)可無(wú)侵襲性地對(duì)髓內(nèi)腫瘤進(jìn)行水分子擴(kuò)散評(píng)估。(2)脊髓腫瘤發(fā)生時(shí),病變區(qū)的FA值、ADC值較正常脊髓組織發(fā)生明顯變化。(3)DTI能夠直觀地顯示頸髓疾病所致白質(zhì)神經(jīng)纖維束的形態(tài)學(xué)改變,有助于對(duì)椎管內(nèi)占位病變的定位診斷,并指導(dǎo)手術(shù)切除。
[Abstract]:Objective: to investigate the significance of diffusive Zhang Liang (DTI) in the diagnosis and treatment of intramedullary tumors of the spinal cord. Methods: imaging examinations were performed in 7 patients with intramedullary tumors of the cervical spinal cord, including routine MR scan of spinal cord, 3D scan and DTI, tracer (DTT) reconstruction of spinal cord. The instrument is a 3.0T MRTRIOTIM scanner (Siemens Company). The post-processing workstation of syngo MRB15 version of NUMARIS/4 software is used for post-processing. The average diffusion coefficient (Average Diffusion Coefficient ADC) and the partial anisotropic (Fractional Anisotropy FA) value of lesion and normal cervical spinal cord are calculated. And combined with the results of the diagnosis and treatment plan, clinical observation. To investigate the diagnostic value of postoperative recovery in patients with intramedullary tumors. Results: one patient underwent surgical treatment with satisfactory results. The localization of pathological changes was consistent with that of DTI. The rest of the patients will be followed up regularly after their doctors have specified the risks of the operation and have decided not to do so for the time being. Conclusion: (1) DTI imaging can noninvasively evaluate intramedullary tumors by water molecular diffusion. (2) when spinal cord tumors occur, (3) DTI can visualize the morphological changes of the white matter nerve fiber bundle caused by cervical spinal cord disease, which is helpful to the localization diagnosis of the space-occupying lesions in the spinal canal and guide the surgical excision.
【學(xué)位授予單位】：首都醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R445.2;R739.42

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