【摘要】：目的:分析多模態(tài)MRI結(jié)合超聲輔助手術(shù)的腦膠質(zhì)瘤病人的臨床資料,探討多模態(tài)MRI中MRS在判斷腫瘤級(jí)別、DTI在設(shè)計(jì)手術(shù)入路及避免腦皮質(zhì)纖維束損傷、超聲提高腫瘤切除程度等方面的應(yīng)用價(jià)值。方法:收集2015年1月至2016年12月收集2015年1月至2016年12月我院神經(jīng)外科術(shù)后病理明確為膠質(zhì)瘤病人資料87例,使用多模態(tài)MRI結(jié)合超聲顯微手術(shù)切除腫瘤病人資料41例,另外46例病人根據(jù)常規(guī)MRI顯微手術(shù),評(píng)估兩組病人腫瘤切除程度及預(yù)后相關(guān)評(píng)分差別。結(jié)果:(1)高、低級(jí)別腦膠質(zhì)瘤瘤體Lac峰比較:x2值=2.303,P0.05高、低級(jí)別腦膠質(zhì)瘤瘤體Lip峰比較:x2值=4.830,P0.05。(2)檢驗(yàn)示纖維束的形態(tài)差異Z=17.688,P0.05。(3)使用顯微手術(shù)腫瘤全切率54.35%,使用超聲輔助顯微手術(shù)腫瘤全切率75.61%,x2值=4.272,P0.05。(4)預(yù)后評(píng)估:使用常規(guī)MRI顯微手術(shù)的術(shù)后KPS評(píng)分=73.89±10.83,使用多模態(tài)MRI輔助顯微手術(shù)的術(shù)后KPS評(píng)分=84.75±10.83,t值=2.993,P0.05。結(jié)論:多模態(tài)MRI技術(shù)中波譜分析技術(shù)有利于判斷腫瘤的良惡性程度,彌散張量成像技術(shù)可提示腫瘤與重要纖維束的毗鄰關(guān)系,通過(guò)皮質(zhì)纖維束形態(tài)改變判斷腫瘤級(jí)別、設(shè)計(jì)手術(shù)路徑,結(jié)合超聲可準(zhǔn)確定位、明確腦膠質(zhì)瘤界限,在保護(hù)神經(jīng)功能同時(shí)最大限度切除腫瘤,顯著提高腫瘤全切率,有效避免病人術(shù)后出現(xiàn)永久性功能損傷,改善預(yù)后。
[Abstract]:Objective: to analyze the clinical data of glioma patients undergoing multimodal MRI combined with ultrasound assisted surgery, and to explore the role of MRS in judging tumor grade in multimodal MRI and the design of surgical approach for DTI in order to avoid cortical fiber bundle injury. Application value of ultrasound in tumor resection. Methods: from January 2015 to December 2016, 87 patients with glioma were collected from January 2015 to December 2016, and 41 patients were resected by multi-mode MRI combined with ultrasound microsurgery. According to conventional MRI microsurgery, 46 patients were evaluated for tumor resection degree and prognostic scores. Results: (1) comparison of Lac peak in high and low grade gliomas: x2 = 2.303%, Lip peak in low grade gliomas: x2 = 4.830 (P0.05). (2) the morphological differences of fibrous bundles were observed. P0.05. (3) Total removal rate of tumor was 54.35 by microsurgery, total removal rate of tumor by ultrasound assisted microsurgery was 75.61x2 = 4.272, P0.05. (4) prognosis: the postoperative KPS score of conventional MRI microsurgery was 73.89 鹵10.83, and the postoperative KPS score of multimodal MRI assisted microsurgery was 84.75 鹵10.83 t = 2.993U P0.05. Conclusion: the spectral analysis of multimodal MRI is helpful to judge the degree of benign and malignant tumor. Diffusion Zhang Liang imaging technique can indicate the adjacent relationship between tumor and important fibrous bundles, and judge the grade of tumor by cortical fiber bundle morphological change. The operative path was designed, combined with ultrasound to locate the brain glioma accurately, to define the boundary of glioma, to remove the tumor at the same time as protecting the nerve function, to increase the total resection rate of tumor, to avoid the permanent functional injury and to improve the prognosis after operation.
【學(xué)位授予單位】：新疆醫(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)】：R739.41

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