The Predictive Value Of Diffusion Tensor Imaging-based Tractography In The Postoperative Motor Dysfunction Of Patients With Gliomas Adjacent To Corticospinal Tract

Objective:Objective to investigate the predictive value of preoperative diffusion tensor imaging(DTT)for postoperative motor dysfunction in patients with gliomas adjacent to the corticospinal tract(CST).Method : Objective To retrospectively study and analyze the clinical data of patients with adjacent CST and postoperative pathological diagnosis of glioma admitted to our center from March 2019 to September 2020.All patients underwent conventional MRI and DTT before operation.The patients were followed up 1week and 3 months after operation to evaluate the motor dysfunction.The characteristics of preoperative DTT images and their correlation with postoperative motor dysfunction were analyzed.The characteristics of DTT images before operation included the shortest distance(LCSD)from the edge of tumor to CST,the change of CST(displacement,interruption and infiltration caused by glioma)and the characteristics of tumor(location,edema and necrosis).According to LCSD value,they were divided into short distance group(≤ 10 mm)and long distance group(> 10 mm).One week after operation,motor dysfunction was defined as short-term motor dysfunction,and three months after operation,motor dysfunction was defined as long-term motor dysfunction.Univariate and multivariate logistic regression analysis were used to study the risk factors of short-term and long-term postoperative motor dysfunctionResult:A total of 35 patients with glioma were included in this study.According to the preoperative DTT images,25 cases(71.4%)in the short distance group and 10 cases(28.6%)in the long distance group,14 cases(40.0%)had CST changes,and20 cases(57.1%)had tumor necrosis.There were 14 cases(40.0%)with total tumor resection and 24 cases(60.0%)with subtotal tumor resection.One week after operation,18 patients(51.4%)had short-term motor dysfunction;three months after operation,11 patients(33.3%)had long-term motor dysfunction.In multivariate logistic analysis,CST change(P = 0.033)and LCSD group(P = 0.046)were significantly associated with recent motor dysfunction.Tumor necrosis(P =0.047)was significantly associated with long-term motor dysfunctionConclusion:The shortest distance from the edge of tumor to CST on preoperative DTT images was more than 10 mm,and the risk of short-term motor dysfunction was lower.The change of CST on DTT before operation may be a risk factor for motor dysfunction in the near future after operation.Preoperative tumor necrosis on DTT may be a risk factor for long-term postoperative motor dysfunction.