DTI With Intra-operative Ultrasound For Surgery Of Deep Brain Gliomas

Objective:To explore the role of diffusion tensor imaging(DTI) and intra-operative ultrasound(IOUS) guiding technique for surgery of deep brain glioma. Method: 38 patients newly confirmed in deep brain glioma were as trial group. The control group were 28 patients that using conventional MRI for surgical planning. In the trial group, the surgical approach was designed by DTI, which showed the relationship between the tumor and white matter tracts. The boundary resection in the operation was determined to be using IOUS. The lesion resection of the control group was only assisted by conventional MRI. Post-operatively, all patients underwent enhanced brain MRI within 72 hours to ascertain extent of resection. Patients were followed in our outpatient clinic over 3-6 months. Neurological deficits Karnofsky performance scoring(KPS) were evaluated. Results: There were no significant differences in balance test indexes of preoperative data. The ratio of gross total resection of trail group was higher than that of control group(P<0.05). The statistical analysis also showed the ratio of postoperative morbidity in trail group was significantly lower than that of control group(P<0.05). The mean Karnofsky scale were 76.04±10.83 and 84.87±10.81 respectively in control group and trial group(P<0.05).Conclusion: MR-DTI and IOUS guiding for surgery of glioma deep located in brain can increase the gross total resection rate, decrease the paralysis rate caused by surgery. These tools are helpful to design a reasonable surgical plan for preserving white matter tracts while maximizing the tumor resection. MRI-DTI and IOUS guiding for surgery of glioma deep located can improve patient quality of life compared with traditional glioma surgery.