Study on application value of diffusion tensor imaging on postoperative visual pathway recovery in patients after surgery for pituitary adenoma
Objective To analyze the characteristics and influencing factors of changes in visual pathway diffusion tensor imaging(DTI)indicators in patients undergoing pituitary adenoma surgery before and after surgery,and quantitatively analyze the relationship between visual function results and the severity of microstructural damage using DTI parameters to explore the postoperative visual recovery of patients with pituitary adenoma.Methods 22 patients who were diagnosed with pituitary adenoma and underwent surgical treatment were selected.The basic data,DTI examination and visual acuity examination data of patients were collected preoperatively,at first postoperative examination and the second postoperative examination.The anisotropy fraction(FA)values and apparent diffusion coefficient(ADC)values of the patients in different periods were compared.The correlation of binocular visual acuity recovery with their age and gender,as well as the mean value of preoperative FA in the left and right eyes with visual function were analyzed.Results There were significant differences in FA and ADC at the first postoperative examination compared with those preoperatively(P<0.05),with the preoperative paired FA values in the left eye and the right eye increasing by 0.09 and 0.08,respectively,while the preoperative paired ADC values in the left eye and the right eye decreasing by 0.25×10-10 m2/s and 0.39×10-10 m2/s.The preoperative FA and ADC values were significantly different compared to the second postoperative examination(P<0.05),with the preoperative paired FA values in the left and right eyes increasing by 0.13 and 0.11,respectively,and the preoperative paired ADC values in the left and right eyes decreasing by 0.49×10-10 m2/s and 0.51×10-10 m2/s,respectively.Compared with the second postoperative examination,the FA and ADC values were significantly different at the first postoperative examination(P<0.05),with the preoperative paired FA values in the left and right eyes increasing by 0.04 and 0.03,respectively,and the preoperative paired ADC values in the left and right eyes decreasing by 0.24×10-10 m2/s and 0.12×10-10 m2/s,respectively.The above results showed that with the recovery of postoperative visual field,FA value increased significantly while ADC value gradually decreased.Correlation analysis showed that there was no correlation between age,gender and postoperative visual pathway recovery(P>0.05).Preoperatively,0 cases had visual function in grade 1,16 cases in grade 2,5 cases in grade 3,and 1 case in grade 4.Continuously checking the visual function scores of the patients at all postoperative periods,all patients showed a trend of decreasing visual acuity scores and visual function was in the process of continuous improvement.At the second postoperative examination,14 cases had visual function in grade 1,7 cases in grade 2,1 case in grade 3,and 0 cases in grade 4.Visual function scores were performed on both eyes of the patients,and the correlation coefficient between the preoperative FA values of the right and left eyes and the preoperative visual acuity scores was-0.688,which was negatively correlated(P<0.05).Conclusion DTI,as a non-invasive visual pathway detection method,can predict the possible degree of postoperative visual recovery in patients before surgery.And within a certain period of time after surgery,the recovery of vision is positively correlated with time.
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