The application of magnetic resonance diffusion tensor imaging for evaluation of optic radiation injury in patients with hypertensive putaminal hemorrhage / 中国神经精神疾病杂志

Objective We attempted to investigate optic radiation (OR) injury and visual field mean defect (MD) in patients with hypertensive putaminal hemorrhage by using diffusion tensor imaging (DTI). Methods Thirty-three first onset of patients with hypertensive putaminal hemorrhage and 30 normal healthy control subjects were recruited. DTI data were acquired between 3 and 5 days as well as 3 months after onset. DTI-Studio software was used to reconstruct the OR and examine the degree of OR injury (typeⅠ, Ⅱ, and type Ⅲ). Fractional anisotropies (FA) and apparent diffusion coefficient (ADC)values of the ORs were measured. Statistical analysis was performed to calculate hematoma volume, MD,OR-FA and ADC values by using SPSS 17.0 software. Results FA and ADC values of ORs were not significantly different between the two hemispheres in normal control groups (student t-test, P>0.05). Compared with MD values in control group, the visual field was significantly impaired in patients group (P<0.01). FA and ADC values of ORs were significantly different between two hemispheres in patient group (student t-test, P<0.01). There was no correlation of hematoma volume with OR-FA nor with ADC values nor with MD values (P>0.05). The MD values were correlated with OR-FA and ADC values after onset(P<0.05). MD, FA and ADC values of ORs in the affected hemisphere of the patient group were significantly different for the three OR types between 3 and 5 days as well as 3 months after onset (P<0.01). Conclusion DTI can examine the three-dimensional relationship between hematoma and OR, reflect the changes of OR morphology and predict the degree of visual-field defects.

Microsurgical management of meningiomas in the trigone of the lateral ventricle / 医学研究生学报

Objective Meningiomas in the trigone of the lateral ventricle are characterized by deep location and low inci-dence. A few studies have been done on its treatment at home and abroad. This study was to explore the access,techniques,and clini-cal effect of microsurgery for lateral ventricular trigone meningiomas (LVTM). Methods We retrospectively analyzed the clinical data about 36 cases of LVTM treated by microsurgery in our hospital from December 2011 to December 2015. The operation involved lumbar cistern tube drainage, intraoperative drainage of cerebrospinal fluid, a unilateral parieto-occipital U-shaped cut, approach through the interparietal fissure,a sagittal incision about 3 cm long at the interparietal fissure for exposure and resection of the tumor. We followed up the patients for a mean of 17 months postoperatively and analyzed the results and complications. Results Simpson grade I removal of the tumors was achieved in all the 36 cases. Postoperative complications included homonymous hemianopia in 4 cases, central nervous system infections in 3,secondary epilepsy in 2,subcutaneous hydrops in 2,and intratumoral hemorrhage in 1 (which necessitated a second operation). Extended temporal horn of the right lateral ventricle occurred at 32 months after surgery,which was treated by fistulation. Homonymous hemianopia was improved in 2 of the 4 ca-ses. All the patients were capable of daily life activities and none experienced recurrence. Conclusion Sufficient preoperative evalu-ation of the tumor characteristics,rational selection of surgical approach,and expert operation techniques are the key factors for the mi-crosurgical treatment of meningiomas in the trigone of the lateral ventricle.

Evaluation for Injury in Optic Radiation after Ischemic Stroke with Diffusion Tensor Imaging / 中国康复理论与实践

Objective To evaluate the injury of optic radiation after ischemic stroke with diffusion tensor imaging (DTI). Methods From September, 2014 to September, 2015, twenty-one ischemic stroke inpatients with visual field defects were tested with DTI, and measured the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of both sides in different time. The correlation of FA and ADC to visual field mean defect (MD) in the same time was analyzed. Results The FA of affected sides was lower than that of healthy sides twenty-four hours (t=2.38, P<0.05), one week (t=15.60, P<0.01) and four weeks (t=19.13, P<0.01) after stroke, and the ADC was also lower twenty-four hours (t=10.13, P<0.01) and one week (t=6.06, P<0.01) after stroke. The FA correlated with MD one (r=0.581, P<0.01) and four weeks (r=0.703, P<0.01) after stroke, and the ADC correlated with MD twenty-four hours after stroke (r=0.519, P<0.05). The FA of one (r=0.525, P<0.05) and four weeks (r=0.762, P<0.01) after stroke correlated with MD six months after stroke. Conclusion DTI can be used to evaluate the injury of optic radiation after ischemic stroke.

Ocular manifestations of intraventricular trigonal meningioma and the associated optic radiation injury / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract? AIM: To analyze the ocular manifestations of meningiomas in the trigone of the lateral ventricle, discuss the relevant factors of visual impairment in these patients and things need attention clinically.?METHODS:Retrospectively study on the clinical data of 90 eyes in 45 patients diagnosed of trigonal meningiomas treated at Beijing Tian Tan Hospital from October 2011 to October 2015.Preoperative examinations including visual acuity, optic disc findings, visual field, size of tumors and other change in MRI were analyzed.?RESULTS: Patients'age was 12-68 years old ( mean 41.7 ±13.7 years ). Male/female ratio was 1 ∶4.6. Decreased visual acuity occurred in 18 eyes.Optic disc edema was found in 24 eyes and optic disc pale in 6 eyes. Fourty -seven eyes had visual field defect, mostly homonymous hemianopia or defect. The maximum diameter of tumors was 2.1-9.6cm (4.8±1.7cm).Range of tumor volume was 3.02-193.2cm3(48.3±47.8cm3).A positive correlation of preoperative visual field defect was found with tumor volume, tumor maximum diameter, and brain midline shift respectively. While the preoperative visual field defect was not found any correlation with age, gender, course, and the enlargement of the ventricle and the edema of the tissue around the tumors. After Mann-Whitney U test, the differences on tumor volume, the maximum diameter of tumors, and brain midline shift between the two groups were significant.? CONCLUSION: Patients with trigonal meningiomas often have ocular signs and symptoms.The major reason of visual field defect is the damage of optic radiation around the tumor.The specific position of injured optic radiation determines the type and extent of visual field defect.Both ophthalmologist and neurosurgeon should pay attention to tumors nearby posterior visual pathway. Doing neurophthalmology examinations for these patients and realizing the position between the tumor and posterior visual pathway will be helpful and necessary in surgical planning.

Application of MRI volume rendering in surgical approach by superior temporal sulcus-temporal horn of lateral ventricle / 吉林大学学报(医学版)

Objective To acquire some related data of surgical approach through brain superior temporal sulcus to temporal horn of lateral ventricle by MRI volume rendering, and to orientate the point of superior temporal sulcus on the lateral surface which is closest to temporal horn of lateral ventricle,and to find out the best entrance point of surgical approach through superior temporal sulcus to temporal horn of lateral ventricle.Methods 120 adult cases of MRI scanning specimens were chosen for measurement. MRI volume rendering technology was used to rebuild the brain 3D model for the measurement of the full length of superior temporal sulcus S1 .Then cutting along the prependicular to the direction of the long axis of the temporal lobe with 1.0 mm spacings,the coronal sections were obtained,and the distance from superior temporal sulcus to temporal horn of lateral ventricle was ordinally measured and the shortest distance S2 was made sure.And the depth of superior temporal sulcus S3 was detected. The corresponding point on the surface of the brain at superior temporal sulcus according to the point leading the shortest distance S4 was determined. The ratio of S4 to S1 M was calculated. The angle between the shortest distance and median sagittal plane asαwas determined.All the samples were measured on both sides of the brain and all the data were compared.Results The S1 of the 120 cases was (159.56 ± 17.55)mm on the left and (164.35± 15.07)mm on the right,there was no statistical difference between two cerebral hemispheres(P>0.05);the S2 was (8.18±0.96)mm on the left and (7.81±0.90)mm on the right,there was no statistical difference between two cerebral hemispheres(P>0.05);the S3 was (12.19±1.43)mm on the left and (11.57± 1.33)mm on the right,there was no statistical difference between two cerebral hemispheres(P>0.05);the S4 was (100.88±16.09)mm on the left and (104.15±14.49)mm on the right,there was no statistical difference between two cerebral hemispheres(P>0.05);the M was (0.63 ±0.07)on the left and (0.63 ±0.06)on the right,there was no statistical difference between two cerebral hemispheres(P>0.05);theαwas (55.80±3.64)°on the left and (56.46±4.17)°on the right,there was no statistical difference between two cerebral hemispheres(P>0.05). Conclusion The point at the front side 3/5 of superior temporal sulcus may be the ideal surgical approach entrance point.The distance from the point to temporal horn of lateral ventricle is shortest.It indicates that the approach can reduce the damage of brain tissue.

The application of mr dti in cerebra infarction of optic radiation / 实用放射学杂志

Objective To evaluate the fiber altering and clinical relationship in patients with occipital and temporal lobe cerebral infarction with DTI.Methods Fifty patients suffering from cerebral stroke were analyzed with conventional MRI,DWI and DTI. The fibers of visual pathway were depicted ,and their fractional anisotropy (FA),apparent diffusion coefficient (ADC),isotropic im-age (Iso)and T2-weighted trace were measured and analyzed.Results Regions of interest (ROIs)were placed in infarction and nor-mal contralateral tissue for tracking the visual pathways.The different parameters were measured.FA is useful to differentiate hy-per-acute stroke from acute and sub-acute stroke.FA values increased slightly in hyper-acute and decreased in acute,sub-acute and chronic phase.The values of ADC in infarction regions in hyper-acute,acute and sub-acute phases were lower than those of the con-tralateral tissue.Iso and T2-weighted trace increased in acute phase and decreased in chronic phase.DTT was used to show the way and chang of visual pathway.Conclusion DTI could track the fiber of visual pathway,and depict the fiber of infarction zone.DTT could be used in evaluating the prognosis of patients.

Comparative Study on the Changes of DTI and DTT of Optic Radiation and the Defect of Visual Field / 实用放射学杂志

Objective To study the relationship between the changes of diffusion tensor imaging(DTI)and diffusion tensor tractography(DTT)of optic radiation and the defect of visual field.Methods DTI and DTT were performed in 37 patients with invasion of the optic radiation by intracranial lesions and in 20 normal control group at 3.0T MR scanner,the visual fields of all cases were examined.The relativity between FA values,ADC values and mean sensitivity(MS)values,mean defect(MD)values of visual field and the relativity between the morphological change of optic radiation and the defect of visual field were analysed.Results In comparison with control group,FA values decreased and ADC values increased in subject group,there were statistically significant differences(P＜0.001)between them.In disordered group,FA values were positive correlation with MS values(r=0.718)and negative correlation with MD values(r=-0.694);ADC values were negative correlation with MS values(r=-0.625)and positive correlation with MD values(r=0.538).DTT showed that the ventral tracts of optic radiation were damaged which oppeared as the defect of ditto quadrant of bilateral field vision in 9 cases,the dorsal tracts and the lateral tracts of optic radiation were damaged which appeared as the defect of inferior quadrant of bilateral field vision in 7 cases,the optic radiations were damaged extensively that caused symmetric or asymmetric congruous hemianopia of bilateral field vision in 21 cases.Conclusion DTI and DTT of optic radiation are intimately correlated with the examined results of visual field,it will be a objective index to extimate the function and the morphological changes of optic radiation.

MR-DTI Study on Wallerian Degeneration of the Optic Radiation after Occipital Lobe Chronic Infarction / 实用放射学杂志

Objective To evaluate the possibility of diffusion tensor imaging(DTI)in detecting and quantifying the Wallerian degeneration of optic radiation in occipital lobe chronic infarction.Methods 20 patients with unilateral occipital chronic infarction were undergone DTI.Quantitative fractional anisotropy(FA)and mean diffusivity(MD)were obtained from the ipsilateral optic radiation of the occipital lobe infarction and compared with that of contralateral region using the independent samples t-test.Results On the three dimensional color-coding tensor fractional anisotropic map,the regions of occipital lobe chronic infarction were markedly low signal intensity,the FA value and MD value were 0.274?0.062 and(1.226?0.372)?10-3mm2/s,while in the contralateral region of optic radiation,FA and MD values were 0.495?0.035 and(0.775?0.070)?10-3mm2/s respectively,there was significant difference in FA and MD values in comparing both side(P〈0.01).Conclusion DTI can detect and quantify the Wallerian degeneration in optic radiation after occipital lobe chronic infarction.

Application of monitoring lumpectomy of lesion adjacent to the optic radiation using real-time visual evoked potential and diffusion tensor tractography / 临床神经病学杂志

Objective To investigate the applied value of diffusion tensor tractography(DTT) and visual evoked potential(VEP) for monitoring lumpectomy of lesion adjacent to the optic radiation.Methods Six patients with intracranial lesions adjacent to the optic radiation performed MRI DTT before operation in order to know relationship between the optic radiation and lesion.Neuronavigation was performed and VEP was recorded continuously during the operation.Results Pathological results of specimens showed that 2 cases were astrocytoma(WHOⅡ),1 case was oligodendroglioma(WHOⅡ),1 case was oligodendro-astrocytoma(WHOⅡ),1 case was anaplastic astrocytoma(WHOⅢ～Ⅳ),1 case was cavernous angioma.No patients were found visual deficit and VEP of 6 cases were normal postoperatively.Conclusions Combination neuronavigation with optic radiation DTT preoperatively and neuronavigation with real-time VEP intraoperatively are reliable to monitor the visual function and is helpful to perform neurosurgical planning near the visual pathway to avoid vision postoperative dysfunction.

INFARCTION OF OCCIPITAL CORTEX AND OPTIC RADIATIONS CAUSING ISCHE-MIOPATHY OF POSTERIOR VISUAL SYSTEM (IPVS) / 解放军医学杂志

Five male and one female patients with IPVS caused by infarction of occipital cortex and optic radiations of brain were reported. The ages were in the range from 21 to 69 years. The evidence of diagnosis included sudden loss of visual acuity in both eyes, normal fundus, homonymous defect of visual field, infarction of brain in CT scan, without other positive signs of central nervous system or headache or eye pain before or at the time of attack. All the patients were treated by injection of Co- Anisodine Ⅰ and Ⅱ at acupuncture points with satisfactory effects. The therapy is safe, effective, and reliable. The clinical features and the treatment mechanism were disscused.