Clinical use of diffusion tensor imaging combined with neuronavigation for brain tumor surgeries

Objective To investigate the guiding significance of Diffusion Tensor Imaging (DTI)combined with neuronavigation for brain tumor surgeries. Methods Fifteen cases of glioma and 6 cases of meningioma underwent conventional MRI scan,contrast-enhanced MRI and DTI before the operations.Three-dimensional trajectories were reconstructed from diffusion tensor imaging(DTI) data by using white matter fiber tract mapping.The surgical planning,approach and resection range were determined according to the reconstructed images.The brain tumor tumorectomy was performed under a microscope combined with neuronavigation. Results Among 15 cases of glioma,6 cases showed simple displacement,9 cases showed both displacement and disruption;among 6 cases of meningioma,4 cases showed simple displacement,2 cases showed displacement and a small amount of disruption.The total resection(13 cases) and subtotal resection(2 cases) were performed for 15 cases of glioma,and few nerve fiber damage by surgical injury occurred.The total resection was performed in all 6 cases of meningioma,and there was no nerve fiber damage.12 patients with preoperative symptoms of neurologic function loss displayed obvious improvement in 6 months.2 cases suffered from new-onset partial motor aphemia that recovered in 6 months,2 cases suffered from new-set hemiplegia,1 case recovered in 6 months,1 case didn't improved. Conclusion DTI combined with neuronavigation can guide the brain tumor surgery at maximum extent on the basis of protecting of nerve function.