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1、弥散张量联合荧光素钠指导功能区胶质瘤手术治疗价值张海旺1，张苓1，陈礼刚1，彭里磊1，周杰1，陆笑非2，酉建1，刘洛同1，明扬1（646000四川泸州，泸州医学院附属医院:神经外科1，影像科2）[摘要]目的探讨术前弥散张量成像（diffusiontensorimaging，DTI)联合术中荧光素钠显像指导功能区胶质瘤手术治疗价值。方法对2010年2月至2011年6月在我院采用DTI联合荧光素钠手术和传统手术治疗且获得随访月份≦24月的功能区胶质瘤患者的病历资料进行回顾性分析，DTI联合荧光素钠组21例术前均行增强MRI、DT
2、I联合术中应用荧光素钠显像,传统组22例术前均行增强MRI。术后第1天均行增强MRI检查患者肿瘤切除程度、术后2周用Karnofsky评分评价患者生存质量、术后均行同步放化疗3个月以上，观察患者术后2年的生存率。结果术后增强MRI示观察组在肿瘤的全切率上显著高于对照组，术后2周Karnofsky评分观察组显著高于对照组，观察组术后2年的生存率显著高于对照组，差异有统计学意义（P<0.05）。结论弥散张量成像联合荧光素钠显像技术能确保术中最小程度破坏功能纤维束而最大程度切除肿瘤，提高患者生存质量和生存时间。[关键词]胶质瘤；荧
3、光素钠；弥散张量成像[中图法分类号]R605；R739.41[文献标志码]AClinicvalueofdiffusiontensorimagingandfluoresceinsodiuminoperationofgliomasinorneartheeloquentregionZhangHaiwang,ZhangLing,ChenLigang,PengLilei,ZhouJie,YouJian,LiuLuotong,MingYang(DepartmentofNeurosurgery,TheAffiliatedHospitalo
4、fLuzhouMedicalCollege,Luzhou,646000,LuXiaofeiDepartmentofRadiology,TheAffiliatedHospitalofLuzhouMedicalCollege,Luzhou,646000)[Abstract]ObjectiveToinvestigatethevalueofdiffusiontensorimagingandfluoresceinsodiuminresectionofgliomasinorneartheeloquentregion.MethodsTor
5、etrospectivelyinvestigatepatientswithgliomasinorneartheeloquentregioninourhospitalfromFebruary2010toJune2011.Thesepatientswerefolloweduplessthan24monthsanddividedinto2groupsDTIcombinatedwithcontrolgroupandobservationgroup.21patientsinobservationgroupwereunderwenten
6、hancedMRI,DTIbeforeoperationandwereinjectedfluoresceinsodiumduringoperation.22patientsincontrolgroupwereunderwentenhancedMRIbeforeoperation.AllpatientswereunderwentenhancedMRItoassessthedegreeofresection1dayaftertheoperation;Karnofskyscorewasusedtoevaluatepatients'
7、qulityoflife2weeksaftertheoperation;Allpatientswereunderwentchemoradiotherapyafteroperationformorethan3months.Two-yearsurvivalrateofpatientswasobserved.ResultsTotaltumorremovalratebasedonenhancedMRI,Karnofskyscore2weeksafteroperationandtwo-yearsurvivalrateinobserva
8、tiongroupwerehigherthanthoseincontrolgroup.Thedifferencebetween2groupswasstatisticallysignificant(P<0.05).ConclusionsTheapplicationofdiffusionten
