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首页> 外文期刊>Neurosurgical focus >Visualization of nerve fibers and their relationship to peripheral nerve tumors by diffusion tensor imaging
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Visualization of nerve fibers and their relationship to peripheral nerve tumors by diffusion tensor imaging

机译：通过扩散张量成像，神经纤维的可视化及其与周围神经肿瘤的关系

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OBJECT The majority of growing and/or symptomatic peripheral nerve tumors are schwannomas and neurofibromas. They are almost always benign and can usually be resected while minimizing motor and sensory deficits if approached with the proper expertise and techniques. Intraoperative electrophysiological stimulation and recording techniques allow the surgeon to map the surface of the tumor in an effort to identify and thus avoid damaging functioning nerve fibers. Recently, MR diffusion tensor imaging (DTI) techniques have permitted the visualization of axons, because of their anisotropic properties, in peripheral nerves. The ^w>OBJECT of this study was to compare the distribution of nerve fibers as revealed by direct electrical stimulation with that seen on preoperative MR DTI. METHODS The authors conducted a retrospective chart review of patients with a peripheral nerve or nerve root tumor between March 2012 and January 2014. Diffusion tensor imaging and intraoperative data had been prospectively collected for patients with peripheral nerve tumors that were resected. Preoperative identification of the nerve fiber location in relation to the nerve tumor surface as seen on DTI studies was compared with the nerve fiber’s intraoperative localization using electrophysiological stimulation and recordings. RESULTS In 23 patients eligible for study there was good correlation between nerve fiber location on DTI and its anatomical location seen intraoperatively. Diffusion tensor imaging demonstrated the relationship of nerve fibers relative to the tumor with 95.7% sensitivity, 66.7% specificity, 75% positive predictive value, and 93.8% negative predictive value. CONCLUSIONS Preoperative DTI techniques are useful in helping the peripheral nerve surgeon to both determine the risks involved in resecting a nerve tumor and plan the safest surgical approach.
机译：对象大多数生长和/或症状周围神经肿瘤是Schwannomas和神经纤维瘤。它们几乎总是良性，通常可以在最小化电动机和感官缺陷的情况下，如果接近正确的专业知识和技术。术中电生理刺激和记录技术允许外科医生在努力识别并因此避免破坏功能神经纤维的努力。最近，由于它们在外周神经中，MR扩散张量成像（DTI）技术允许轴突的可视化。本研究的目的是将神经纤维的分布进行比较，如在术前先生DTI所示的直接电刺激所揭示的。方法方法对2012年3月至2014年1月至2012年3月至2014年1月的外周神经或神经根瘤患者进行了回顾性的图表审查。患有切除的外周神经肿瘤的患者，对扩散张量成像和术中数据进行了预期。与DTI研究中的神经肿瘤表面相关的神经纤维位置的术前鉴定与使用电生理刺激和录音的神经纤维的术中定位进行了比较。结果有资格研究的23名患者，神经纤维位置对DTI的神经纤维位置与其解剖位置有良好的相关性。扩散张量成像证明了神经纤维相对于肿瘤的关系，灵敏度为95.7％，特异性为66.7％，阳性预测值75％，负预测值为93.8％。结论术前DTI技术可用于帮助周围神经外科医生对既确定引发神经肿瘤的风险，并计划最安全的手术方法。

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