Objective To investigate the application of diffusion tensor tractography in Surgical Patients with Supratentorial Brain Tumors. Methods 17 patients with pathologically proved Supratentorial brain tumors underwent diffusion tensor tractography prior to tumor excision. The vital white matter tracts were reconstructed and the exact locations of the lesion with respect to clinically eloquent white matter tracts were observed in every patient. Then reasonable surgical plan was determined. After operation , the diffusion tensor tractography was performed again and associated white matter tracts were evaluated to investigate the effect of these structures by surgery. Results The relationships between tumors and white matter tracts could be divided into four types:simple displacement, simple infiltration, simple disruption and displacement with disruption. Pyramidal tract was involved in 5 cases,corpus callosum in 14 cases and optic radiation in 3 cases .Conclusion Visualization of the location of vital white matter tracts with respect to brain tumors can be shown before operation by DTT.It will help to work out the reasonable surgical plan and evaluate the effect of these structures by surgery.%目的 探讨弥散张量纤维束成像在幕上脑肿瘤手术中的应用.方法 对17例经病理证实的幕上脑肿瘤术前行DTT,重建出重要的脑白质纤维束,观察其与脑肿瘤的关系,据此制定合理的手术方案.术后再行DTT来评价手术效果.结果 脑肿瘤与脑白质纤维束的位置关系可分为单纯移位、侵润、破坏及移位伴破坏4种类型.5例累及锥体束;14例累及胼胝体;3 例累及视放射.结论 DTT术前可显示脑白质纤维束与脑肿瘤的关系,有助于手术方案的制定和评价手术效果.
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