【摘要】 目的探讨术前弥散张量成像(diffusion tensor imaging,DTI)面神经重建在听神经瘤手术中的价值。方法收集重庆医科大学附属第一医院单发听神经瘤患者62例,随机分为DTI组和对照组;DTI组行术前DTI面神经重建。利用术中电生理作为金标准比较面神经重建准确率;并比较两组在肿瘤全切率、手术时长、术后面神经功能等指标上的差异。结果本研究DTI组面神经重建的准确率为90%(27/30)。DTI组共30例,肿瘤全切/近全切除率93.33%,平均手术时长(7.17±0.91)h,术后面神经功能良好率76.67%;对照组共32例,肿瘤全切/近全切除率84.38%,平均手术时长(7.89±0.76)h,术后面神经功能良好率46.88%。两组在手术时长(t=3.402,P=0.001)及术后面神经功能良好率(χ~2=5.792,P=0.016)上有统计学差异。结论术前DTI面神经重建对听神经瘤手术有重大意义,其有助于提高术中面神经解剖及功能保护能力,同时有效缩短手术时长。更多还原

【Abstract】 Objective To evaluate the value of preoperative facial nerve reconstruction by using diffusion tensor imaging(DTI)in acoustic neuroma surgery. Methods A total of 62 patients with single-sided acoustic neuroma admitted to the First Affiliated Hospital of Chongqing Medical University were enrolled and randomly divided into DTI group and control group. Patients of DTI group underwent preoperative facial nerve reconstruction by DTI. Accuracy assessment of facial nerve reconstruction was evaluated based on intraoperative electrophysiology. Tumor resection rate, operation duration and postoperative facial nerve function were compared between the two groups. Results The accuracy rate of facial nerve reconstruction by DTI was 90%(27/30). The rate of gross total resection, operation duration and postoperative facial nerve function(HB Ⅰ-Ⅱ) were 93.33%, 7.17±0.91 hours, and 76.67% in DTI group, respectively whereas the rate of gross total resection, operation duration and postoperative facial nerve function(HB Ⅰ-Ⅱ) were 84.38%, 7.89±0.76 hours, and 46.88% in control group, respectively. Significant differences on operation duration(t=3.402, P=0.001)and postoperative facial nerve function(HB Ⅰ-Ⅱ)(x~2 =5.792, P=0.016)were found, respectively. Conclusion Preoperative facial nerve reconstruction by DTI is of great importance in acoustic neuroma surgery. It can protect the facial nerve intraoperatively, and shorten the operation duration.更多还原