Abstract: Objective To explore the effect of base note conformal radiotherapy (IMRT) based on multimodal magnetic resonance imaging (MRI) on autonomic nervous response in patients with glioma after surgeryMethods From June 2018 to June 2020,110 patients with malignant glioma diagnosed by surgical cases were collected and they were divided into study group and control group by random number table method,there were 55 patients in each group.Patients in the control group were given intensity-modulated conformal radiotherapy.The patients in the study group were given multimodal magnetic resonance imaging technology examination combined with intensity-modulated conformal radiotherapy.The autonomic nervous response indexes,sleep quality,compliance,adverse reactions,recurrence rate within one year,and survival rate of the two groups of patients were observed.The multimodal MRI indexes of patients in the study group were collected and compared.Results Compared with the control group,the study group's heart rate(HR)significantly reduced,the standard deviation of the mean RR interval(SDNN)of the 24-hour normal heart rhythm,the standard deviation of the mean RR interval every 5 minutes(SDANN),and the normal adjacent RR.The root mean square of the interval difference(rMSSD),the percentage of adjacent normal RR intervals exceeding 50 ms(pNN50),high-frequency power(HF),and low-frequency power(LF)significantly increased(all P＜0.05);Compared with the sleep quality of the control group,the sleep quality of the patients in the study group significantly improved(P＜0.05);There was no significant difference in compliance and adverse reactions between the two groups(all P＞0.05);After a one-year follow-up,it was found that compared with the control group,the recurrence rate of patients in the study group significantly reduced within one year,and the survival rate significantly increased(all P<0.05).The study group was divided into a good prognosis group (n=8) and a poor prognosis group (n=47) according to the prognosis.There was no significant difference in the expression of apparent diffusion coefficient (ADC) measured by DTI between the two groups (P>0.05),but the good prognosis group The other parameters of multimodal MRI in patients were significantly lower than those in the poor prognosis group (P<0.05).Conclusion The application of intensity-modulated radiotherapy combined with multimodal magnetic resonance imaging examination for clinical examination and treatment of postoperative patients with glioma can not only improve patients' sleep and prognosis,improve patients' compliance with treatment,but especially improve patients' autonomic nervous system response At the same time,multimodal magnetic resonance imaging can also be used as an indicator for the prognosis of clinical glioma after surgery,which is worthy of clinical application.

Key words: Multimodal nuclear magnetic resonance imaging, Intensity-modulated conformal radiotherapy, Glioma, Autonomic nerve, Prognosis

摘要： 目的 探究基于多模态核磁共振成像脑胶质瘤术后调强适形放疗对脑胶质瘤术后患者自主神经反应的影响。方法 收集2018年6月~2020年6月本院收治的110例经手术病例确诊的恶性脑胶质瘤患者,采用随机数表法将其分为研究组和对照组,每组患者均55例。给予对照组患者调强适形放疗,给予研究组患者多模态核磁共振成像技术检查联合调强适形放疗。观察两组患者自主神经反应指标、睡眠质量、依从性、不良反应、一年内复发率和生存率;收集对比研究组患者多模态MRI指标。结果 相较于对照组,研究组心率(HR)显著降低,24 h正常窭性心律R-R均值间期标准差(SDNN)、每5分钟R-R间期均值的 标准差(SDANN)、正常相邻R-R间期差值的均方根(rMSSD)、相邻正常R-R间期超过50 ms的百分比(pNN50)、高频功率(HF)和低频功率(LF)显著升高(均P＜0.05);与对照组睡眠质量相比较,研究组患者睡眠质量得到显著改善(P＜0.05);两组患者依从性和不良反应均无显著差异(均P＞0.05);随访一年后,发现与对照组相比,研究组患者一年内复发率显著较低,生存率显著较高(均P＜0.05);将研究组根据预后分为预后良好组(n=8)预后不良组(n=47),两组患者DTI测量表观弥散系数(ADC)表达无显著差异(P＞0.05),但预后良好组患者多模态MRI其他参数均显著低于预后不良组(P＜0.05)。结论 应用调强适形放疗联合多模态核磁共振成像检查对胶质瘤术后患者给予临床检查和治疗,不仅可以改善患者的睡眠和预后,提升患者治疗依从性,尤其可以改善患者自主神经反应情况,同时与胶质瘤术后患者而言,对其行多模拟核磁共振成像,可对其预后进行相应的评估,值得在临床推广应用。

关键词: 多模态核磁共振成像, 调强适形放疗, 脑胶质瘤, 自主神经, 预后