Objective To discuss the effect of diffusion tensor imaging assisted resection of high grade glioma. Meth-ods Twenty-seven cases of high grade gliomas with DTI examination from January 2009 to December 2013 in the Hos-pital of Yutian County in Hebei Province (“our hospital” for short) were as observation group. 20 cases of high grade gliomas from January 2006 to December 2008 in our hospital were selected as control group. The patients of the control group were done MRI and enhanced scan. All patients underwent operation under a microscope. Observation group: the skin incision was chosen to avoid tracts sulci and function area according to the relationship between preoperative tu-mor DTI display and function tracts; control group: according to the results of the preoperative MRI, clear the location and size of tumor they were chosen from the trench into the brain tumor closer. The average diffusion coefficient (MD) and fractional anisotropy index (FA) in different parts of glioma DTI of patients in observation group were observed. The rates of tumor resection post operative nerve function damage of patients in two groups were observed. Results In the observation group, MD values of tumor lesions, peritumoral edema, normal white matter were (1.270±0.259)í10-9, (1.130±0.135)í10-9, (0.819±0.090)í10-9 mm2/s, respectively. MD values of tumor lesions and peritumoral edema were significantly higher than those of normal white matter (P<0.05), but there was no statistically significant difference in the MD value between tumor lesion and peritumoral ede-ma region (P>0.05). FA values of tumor lesions, peritu-moral edema, normal white matter was (0.169±0.023), (0.219±0.030), (0.410±0.050), respectively. Compared with the normal white matter in patients with cerebral glioma, FA value of tumor lesions, peritumoral edema region decreased obviously, the difference was statistically significant (P<0.05); FA value of peritumoral edema region was higher than the tumor lesion, there was statistically significant difference between the two groups (P<0.05). There were 24 patients (88.9%) in the observation group who were totally removed, subtotal resection in 3 cases (11.1%). The control group were totally removed in 16 cases (80.0%), subtotal resection in 2 cases (10.0%), partial resection in 2 cases (10.0%), there was not statistically significant difference between the total removal rate of the two groups (P>0.05). The rate of damage in patients with operation function of the two groups has significant difference (0.0% v s 20.0%, P < 0.05). Conclusion DTI can distinguish high-grade gliomas tumor region, peritumoral edema region and normal white matter regions. There is clinical guiding significance to determine the extent of resection operation and avoid new nerve injury.%目的：探讨弥散张量成像(DTI)技术辅助高级别脑胶质瘤切除术的效果。方法选择2009年1月~2013年12月河北省玉田县医院(以下简称“我院”)收治的行DTI检查的高级别脑胶质瘤患者27例为观察组，选择2006年1月~2008年12月我院20例高级别脑胶质瘤患者作为对照组。对照组患者行MRI常规及增强扫描检查，所有患者手术均在显微镜下完成。观察组手术入路：皮层切口根据DTI显示的肿瘤与脑组织结构的关系，选择避开功能区及传导束的脑沟进入。对照组手术入路：根据患者术前MRI的结果，选择距离肿瘤较近的脑沟进入。比较观察组患者不同部位DTI的平均弥散系数(MD)及部分各向异性指数(FA)值，比较两组患者肿瘤切除率及并发症发生率。结果观察组患者肿瘤病灶区、瘤周水肿区、正常白质区MD值分别为(1.270±0.259)×10-9、(1.130±0.135)×10-9、(0.819±0.090)×10-9 mm2/s，肿瘤病灶区、瘤周水肿区的MD值均明显高于正常白质区(P<0.05)，而肿瘤病灶区的MD值与瘤周水肿区比较差异无统计学意义(P>0.05)。观察组患者肿瘤病灶区、瘤周水肿区、正常白质区FA值分别为(0.169±0.023)、(0.219±0.030)、(0.410±0.050)，与正常白质区比较，脑胶质瘤患者的肿瘤病灶区、瘤周水肿区FA值均明显降低，差异有统计学意义(P<0.05)；瘤周水肿区FA值高于肿瘤病灶区，两者比较差异有统计学意义(P<0.05)。观察组患者全切24例(88.9%)，次全切3例(11.1%)；对照组全切16例(80.0%)，次全切2例(10.0%)，部分切除2例(10.0%)；两组全切率比较差异无统计学意义(P>0.05)。两组患者手术功能损害发生率比较(0.0%比20.0%)，差异有统计学意义(P<0.05)。结论 DTI技术可区别高级别脑胶质瘤肿瘤病灶区、瘤周水肿区及正常白质区，对确定手术治疗方案，避免新的神经损伤等具有重要的临床指导意义。
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