定量评估幕上脑胶质肿瘤继发的皮质脑桥小脑束的扩散张量成像（DTI）指标的变化。
Quantitative assessment of changes in diffusion tensor imaging (DTI) metrics along the courses of the cortico-ponto-cerebellar tracts secondary to supratentorial human brain glial tumors.
机构信息
Russell H. Morgan Department of Radiology and Radiological Science, Division of Neuroradiology, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA.
Department of Diagnostic & Interventional Imaging, University of Texas Houston Medical School, Memorial Hermann Hospital, Houston, TX, USA.
出版信息
Cancer Rep (Hoboken). 2018 Aug;1(2):e1108. doi: 10.1002/cnr2.1108. Epub 2018 Jul 11.
BACKGROUND
The cortico-ponto-cerebellar tract (CPCT) is the largest projection pathway, which synapses at the pons. Remote effects of supratentorial brain tumors have not been evaluated along the infratentorial course of the CPCT.
AIM
The purpose of this study is to evaluate the possible lateralization of the diffusion tensor metrics of the affected CPCT in patients with supratentorial brain tumor.
METHODS AND RESULTS
We included 39 patients with 29 left-sided tumors (LST) and 10 right-sided tumors, retrospectively. We measured the magnitude of changes of the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the CPCT prior to the brain surgery at the level of crus cerebri and middle cerebellar peduncle. Regions of interest (ROIs) were placed on the lateral side of crus cerebri, and ROI-1 (anterior 1/3), ROI-2 (middle 1/3), ROI-3 (posterior 1/3), and ROI-4 were placed at the level of middle cerebellar peduncle. We hypothesized that there would be decreased FA and increased ADC values of the ipsilesional CPCT compared with contralesional CPCT. Ipsilesional FA values were decreased with simultaneous increased ADC value along the CPCT compared with contralesional CPCT in following ROIs, ROI-1 (LST FA: P = .005, ADC: P = .037) and ROI-3 (LST FA: P = .049, ADC: P = .049), respectively. Affected ROI-4 in LST cases also showed lower FA values, although not statistically significant.
CONCLUSION
We observed a statistically significant FA value decrease and ADC increase along the left ROI-1 and ROI-3 as well as the nonstatistically significant FA decrease of the left ROI-4 at the second neuron level when there was a related supratentorial tumor. These findings are suggestive of presynaptic and postsynaptic microstructural changes of these tracts following the presynaptic involvement by a primary supratentorial brain tumor.
背景
皮质脑桥小脑束（CPCT）是最大的投射通路，在脑桥处形成突触。尚未评估幕上脑肿瘤沿 CPCT 的颅后窝行程的远程影响。
目的
本研究旨在评估幕上脑肿瘤患者 CPCT 受累侧弥散张量指标的可能偏侧化。
方法和结果
我们回顾性纳入 39 例患者，其中 29 例为左侧肿瘤（LST），10 例为右侧肿瘤。在脑手术前，我们测量 CPCT 在脑桥小脑脚水平的各向异性分数（FA）和表观扩散系数（ADC）值的变化幅度。在脑桥小脑脚的外侧放置感兴趣区（ROI），在 ROI-1（前 1/3）、ROI-2（中 1/3）、ROI-3（后 1/3）和 ROI-4 放置在中脑小脑脚水平。我们假设与对侧 CPCT 相比，患侧 CPCT 的 FA 值降低，ADC 值升高。与对侧 CPCT 相比，患侧 CPCT 的 FA 值降低，同时 ADC 值沿 CPCT 升高，在以下 ROI 中观察到这种情况，ROI-1（LST FA：P=0.005，ADC：P=0.037）和 ROI-3（LST FA：P=0.049，ADC：P=0.049）。在 LST 病例中，受影响的 ROI-4 也显示出较低的 FA 值，但无统计学意义。
结论
当存在相关幕上肿瘤时，我们在左 ROI-1 和 ROI-3 中观察到 FA 值显著降低和 ADC 值升高，以及左 ROI-4 的 FA 值非显著降低，这表明这些束在原发性幕上脑肿瘤的节前受累后存在突触前和突触后微观结构变化。
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