摘要
目的应用静息态功能磁共振（rs-fMRI）评估经胼胝体－穹窿间入路切除儿童第三脑室内肿瘤对海马相关脑功能的影响。
方法回顾性纳入2015年1月至2017年12月清华大学玉泉医院神经外科手术治疗的第三脑室内肿瘤患儿，共9例。术前，术后1、2、3个月行rs-fMRI扫描，比较手术前后局部一致性（ReHo）、低频振幅（ALFF）、分数低频振幅（fALFF）、默认脑网络（DMN）及以海马为感兴趣区（ROI）的全脑功能连接变化，评估手术对大脑功能的影响。
结果（1）与术前比较，术后1个月左侧额上回ReHo减弱，右侧枕中回、颞中回，左侧中央后回ReHo增强；术后2个月左侧颞上回及右侧中央前回ReHo较术后1个月减弱，差异均有统计学意义（均P〈0.01）；与术前比较，术后2个月各脑区ReHo的差异均无统计学意义（均P〉0.05）。（2）与术前比较，术后1个月术后枕叶ALFF值降低，手术通路ALFF值增高（均P〈0.01）；术后3个月恢复至术前状态（P〉0.05）。（3）与术前比较，术后额叶及枕叶fALFF值降低（均P〈0.01），术后3个月时恢复至术前状态（P〉0.05）。（4）术后1个月DMN中双侧额中回与其他脑区的联系增强，术后3个月向术前状态恢复。手术对海马与全脑的功能连接有一定影响。
结论经胼胝体－穹窿间手术对患儿脑区ReHo、ALFF及fALFF值产生的短期影响可随时间恢复至术前状态；手术未使患者DMN及海马相关脑区之间的联系中断，手术的影响可恢复至术前状态。
ObjectiveTo investigate changes of hippocampus-related brain functions in children following resection of the third ventricle tumors through transcallosal interforniceal approach.
MethodsNine children with the third ventricle tumors were randomly selected at Department of Neurosurgery, Tsinghua University Yuquan Hospital. Resting state functional MRI （rs-fMRI） was scanned for all patients before and after operation. Multiple aspects, including regional homogeneity （ReHo）, ALFF （amplitude of low frequency fluctuations）, fALFF （fractional ALFF） and changes of function connectivity [DMN （default mode network） and hippocampus as ROI （region of interest）] were compared before pre- and post-operative states.
Results（1） At 1 month post operation, the decreased ReHo was observed in the left superior frontal cortex, while the elevated ReHo was seen in the right middle occipital gyrus, middle temporal gyrus and left central gyrus compared with pre-operative conditions. The elevated ReHo was in the left superior temporal gyrus and right central frontal gyrus at 2 months post operation compared with that at 1 month after operation. There was no difference of ReHo between 2 months after operation and preoperative state. （2） At 1 month post operation, decreased ALFF was in occipital lobe, while increased ALFF was observed in regions around surgical pathway. ALFF restored to preoperative state at 3 months post operation. （3） Decreased fALFF was shown in frontal lobe and occipital lobe after operation. At 3 months post operation, the fALFF restored to preoperative state. （4） The contact between bilateral frontal gyri and other brain areas was elevated at 1 month post operation and recovered to preoperative state at 3 months. Surgery had an effect on the connections between hippocampus and the whole brain.
ConclusionsThe short-term effect of transcallosal interforniceal operations on ReHo, ALFF and fALFF in the brain regions of patients could recover to preoperative state with time. The operation may not interrupt the connections between DMN and hippocampus-related brain areas.
作者
朱晋
赵亚鹏
张庆辉
罗斌
徐成伟
何乐
张玉琪
Zhu Jin;Zhao Yapeng;Zhang Qinghui;Luo Bin;Xu Chengwei;He Le;Zhang Yuqi(School of Clinical Medicine, Tsinghna Universit;Department of Neurosurgery, Tsinghua University Yuquan Hospital, Beijing 100040, Chin)
出处
《中华神经外科杂志》
CSCD
北大核心
2018年第5期510-514,共5页
Chinese Journal of Neurosurgery
基金
国家自然科学基金（81470048）
关键词
第三脑室
中枢神经系统肿瘤
海马
儿童
静息态功能磁共振
胼胝体-穹窿间入路
Third ventricle
Central nervous system neoplasms
Hippocampus
Child
Resting-state functional magnetic resonance imaging
Transcallosal interforniceal approach
