| Intracranial glioma is the most common malignant tumor,surgical resection is the most important method of treatment,and as a result,gliomas have more susceptible to invasive or involved in the neighboring areas of brain function, how to maximize the operation to remove the tumor and the protection of the surrounding brain tissue structure is a major problem for neurosurgeons.Blood oxygenation level-dependent functional magnetic resonance imaging of the cerebral cortex makes the protection of important functional areas to achieve, but how to protect nerve fibers in white matter is still one serious problem in the field of neurosurgery,diffusion tensor imaging technology is a new MR technology on the basis of the conventional MRI technology and diffusion-weighted imaging(DWI) techniques,three-dimensional space in the quantitative analysis of the organization of the movement characteristics of water molecules,the image shows the tumor surrounding intuitive important white matter fiber bundles of the following form and morphology as well as the comparative anatomy and tumor location.Purpose:through the application of preoperative DTI technology to optimize surgical approach,evalue prognosis assessment of postoperative limb function and Karnofsky score to explore the application of the technology in the involvement of the pyramidal tract in glioma surgery.In addition,this study assessed prognosis of patients of cerebral hemorrhage in the basal ganglia of five cases whose limb function were affected, analyse of DTI in patients with basal ganglia hemorrhage in long-term recovery of limb function and prognosis assessment.Methods:January 2007-March 2008 in our hospital neurosurgeon involved in 25 cases of hospitalization of the pyramidal tract in patients with glioma,15 cases of male,female 10 cases;the age of 23～72 years[average(48.56±13.13) years old],tumor side:12 cases of right,13 cases of left,18 cases of temporal lobe,seven cases of frontal and temporal lobe.Treatment of patients were informed and voluntary participation in the pilot.According to the table patients will be randomized into 13 cases of the experimental group(conventional magnetic resonance sequences and the DTI sequence scanning) and 12 cases of the control group(conventional MRI scan sequence).5 cases of cerebral hemorrhage in basal ganglia were admited in our hospital and emergency surgery to remove hematoma.A month later underwent postoperative DTI imaging tracer fibers showing bilateral corticospinal tract,analyse of DTI in patients with cerebral hemorrhage in the restoration of limb function and long-term outcome evaluation.Results:1.preoperative information on the two groups balance test results:the principle of randomly selected test group of 13 cases,12 cases of the control group.Two groups of patients with gender,age,lesion location,lesion size,and preoperative limb motor dysfunction and other indicators of well-balanced.2.Pathological:Control group:glioblastoma one cases,nine cases of astrocytoma, small sticks of glioma of two cases;Research group:8 cases of astrocytoma, small sticks of glioma of four cases,glioblastoma one case.3.Effect analysis: All patients were followed up two groups.(1) control group,endoscopic total tumor resection in 8 cases,4 cases of near-total resection,endoscopic total tumor resection rate of 75.0%in control group.Study Group endoscopic total tumor resection in 9 cases,4 cases of near-total resection.69.2%in test group. Information on the application of fourfold table a clear probability of the Fisher Act,P＞0.05,two sets of data had no significant statistical difference.(2) postoperative disability(emerging limb dyskinesia or decline in muscle strength than the pre-operative) control group75.0%,test group 23.1%,the application of fourfold table of the Fisher information clear probability law,P＜0.05,two set of data clearly significant difference.(3) prognosis:control group KPS73.33±12.60, Test group KPS 83.23±5.15,the application of fourfold table Fisher information clear probability law,P＜0.05,significant difference between two sets of data significantly.4.5 cases of patients with hypertensive basal ganglia hemorrhage in four cases of limb function assessment of patients achieved the expected results, one cases of limb function achieved a good recovery,after discharge in both upper and lower extremities four strength,physical activity is normal,there is little symptoms;three cases of adverse physical function.One patient postoperative recovery of limb function does not meet the predicted results.Conclusion:1.DTI technology can be a multi-directional,visual image to show the location of white matter fiber bundle,course,form the organizational structure and its relationship to the surrounding anatomic location.2.DTI technology will enable patients in the preoperative tumor with an accurate picture of the relationship between pyramidal tract anatomy,to achieve targeted during the resection of tumors at the same time,the effective protection of pyramidal tract.3.DTI technology can significantly reduce postoperative morbidity in patients with glioma and improve the quality of life of patients,but in raising the rate of total resection of the tumor under conventional NMR technology with no significant statistical significance.4.DTI fiber bundle imaging tracer for cerebral hemorrhage patients to assess long-term prognosis of limb function to provide a reference.
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