The Application Of BOLD-fMRI In The Protection Of Language Functional Area During Postoperative Radiotherapy Of Cerebral Gliomas

Objective Using the blood oxygen level dependent functional magnetic resonance imaging(BOLD-fMRI)technique to accurately locate the language function area of patients with postoperative radiotherapy for brain gliomas.And use IMRT technology to achieve the maximum protection of the language functional area and improve the life of patients.Methods Twenty-seven patients with unilateral frontal and temporal glioma after radiotherapy were selected.Before radiotherapy,they underwent conventional MRI plain scan,enhanced scan and BOLD-fMRI examination.And the acquired functional images were superimposed on the 3DT1 anatomical image.Using intensity-modulated radiotherapy(IMRT)to develop protective and unprotected radiation therapy programs for language functional areas.By comparing and analyzing the target area conformity index(CI),homogeneity index(HI),the maximum(Dmax),and the mean(Dmean)of PTV,it is evaluated whether the dose of the target area of the protective radiotherapy plan meets the requirements of clinical radiotherapy.By comparing and analyzing the Dmax and Dmean of the language functional area,it is evaluated whether the protective program is superior.Results In routine radiotherapy plans and protective radiotherapy plans,there were no significant differences in CI,HI,Dmax and Dmean between the two regimens(P=0.516,0.097,0.670,0.726).Both of these plans ensure effective therapeutic doses in the target area and the protection of conventional of OARs.Wernicke and Broca areas were lower than the conventional radiotherapy program(P<0.05).Conclusion BOLD-fMRI can accurately locate the shape and location of the language function area.The application of IMRT technology can not only ensure the therapeutic dose in the target area,but also reduce the radiation dose in the language functional area.The risk of language dysfunction after radiotherapy is reduced.In patients with glioma surgery,the activation of the Chinese passage understanding task in the Wernicke area is better than the Chinese reading task on the activation of the Broca area.