颅内脑外肿瘤(Intracranial Extracerebral Tumors，IET)指肿瘤生长在颅内，但肿瘤位于颅骨和脑组织之间，没有侵犯到脑组织中，这些肿瘤并不起源于脑组织，而主要起源于大脑的周围结构。目前对开颅手术对儿童脑患者认知功能的影响尚无一致结论。采用与认知功能相结合的技术进行大脑功能研究，可提供患者认知功能改变的客观依据并研究其作用机制。近红外光谱成像仪(near-infrared spectroscopy，NIRS)是种监测环境接近自然状态、时间分辨率高的神经影像技术，通过监测脑皮层氧合血红蛋白(Oxy-Hb)浓度的变化反映脑功能活动。本研究结合认知功能，利用NIRS对颅内脑外肿瘤患者围手术期的前额叶功能进行研究。 本研究利用韦氏儿童智力量表第4版(The Wechsler Intelligence Scales for Children-4th edition，WISC-IV)测量儿童IET患者在手术前和手术后2周的(Full Scale IQ，FSIQ)和4个合成指数，言语理解指数(Verbal Comprehension Index，VCI)、知觉推理指数(Perceptual Reasoning Index，PRI)、工作记忆指数(Working Memory index，WMI)、加工速度指数(Processing Speed Index，PSI)。同时利用NIRS对32例儿童IET在手术前和手术后2周在静息态下(rest)下和执行言语流畅任务(Verbal Fluency Task，VFT)时测量Oxy-Hb浓度变化，并对血氧变化和总智商及其合成指数进行相关分析。结果显示，儿童IET患者术后的FSIQ、PRI和PSI较术前出现明显的提高(P<0.05)。NIRS监测下患者术后在20通道和27通道(主要位于右前额叶背外侧区)的平均oxy-Hb的浓度高于术前(P<0.05)；未发现患者手术前、后VFT下NIRS数据在45个通道有显著性差异(P>0.05)；Pearson相关分析表明， rest下，患者的FSIQ、VCI、PRI和WMI与于右前额叶背外侧区的Oxy-Hb平均浓度呈现正相关，患者的FSIQ和VCI与眶额叶皮层的Oxy-Hb平均浓度呈现负相关。在VFT下进行NIRS监测，患者的FSIQ、VCI、PRI和PSI与左前额叶背外侧区和眶额叶区的oxy-Hb平均浓度呈现正相关；患者的VCI、PRI与位于左前额叶背外侧区呈现负相关 综上所述，本研究揭示了IET患者围手术期认知功能和血氧变化特点，发现了开颅手术可能会改善患者的认知功能和右额额叶背外侧的血氧水平，两者具有一致性，并未NIRS技术在脑肿瘤中的应用奠定了基础。 关键词：颅内脑外肿瘤；近红外光谱成像；韦氏儿童智力量表；前额叶

 Intracranial Extracerebral Tumors (IET) refers to tumors growing in the brain, but the tumor is located between the skull and brain tissue, and does not invade the brain tissue. In most cases these tumors do not originate from inside the brain but rather from around meninges. Currently there is no consistent conclusion on the influence of craniotomy on the cognitive function of children with IET. Brain function studies using techniques combined with cognitive experiments can provide an objective basis for cognitive changes in patients and their mechanisms of action. Near-infrared spectroscopy (NIRS) is a neuroimaging technique that monitors the brain close to the natural state with high temporal resolution. By using NIRS, the brain function activity is reflected by monitoring changes in the concentration of oxyhemoglobin (Oxy-Hb) in the cerebral cortex. This study is aim to use cognitive-related techniques to identify the perioperative prefrontal function of patients with IET via NIRS. This study used the Wechsler Intelligence Scale for Children 4th Edition (WISC-IV) to test 32 children with IET, before and two weeks after surgery (Full Scale IQ, FSIQ) and Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI), Processing Speed Index (PSI). At the same time, 45-channel NIRS was used to measure the change of Oxy-Hb concentration at prefrontal region in these children while doing a Verbal Fluency Task (VFT). Correlation analysis is conducted on NIRS data and IQ. The results showed that the FSIQ, PRI and PSI of children with IET were significantly higher after the surgery (P<0.05). The average oxy-Hb concentration in patients at 20-channel and 27-channel (mainly in the dorsolateral area of the right prefrontal cortex) was also higher after the surgery (P<0.05). The NIRS data showed no significant difference in all channels (P>0.05) for VFT; Pearson correlation analysis showed that patients had a positive correlation between FSIQ, VCI, PRI and WMI and the average concentration of Oxy-Hb in the dorsolateral region of the right prefrontal lobe. The FSIQ and VCI were negatively correlated with the average concentration of Oxy-Hb in the orbitofrontal cortex. NIRS data under VFT showed a positive correlation between FSIQ, VCI, PRI, and PSI in the anterior and posterior anterior lobes of the left prefrontal cortex. The patient's VCI, PRI, and dorsolateral left anterior has negative correlation. In summary, this study revealed the perioperative cognitive function and blood oxygenation characteristics of patients with IET, and found that craniotomy may improve the cognitive function of patients and the blood oxygen level in the dorsolateral aspect of the right frontal lobe, which may be helpful for future oncology-NIRS related applications. Key words: Intracranial extracerebral tumors; Near-infrared spectroscopy; the Wechsler intelligence scales for children; Prefrontal cortex