磁共振扩散张量纤维束成像评价脑梗死患者皮质脊髓束损伤的价值

发布时间：2018-05-01 20:48

本文选题：脑梗死 + 扩散张量成像　；参考：《中国脑血管病杂志》2015年07期

【摘要】：目的应用磁共振扩散张量成像(DTI)及扩散张量纤维束成像(DTT)评价脑梗死患者皮质脊髓束(CST)损伤程度及与运动功能预后的关系。方法前瞻性纳入脑梗死患者68例,行常规MRI、DWI、DTI检查,并应用DTT技术进行CST三维重组,于发病7 d内和3个月时测量脑梗死区及健侧相应区域白质各向异性分数(FA),采用Fugl-Meyer量表进行运动功能评分,将CST受累程度分为4级。根据治疗后Fugl-Meyer评分情况将患者分为1组(96~99分,大致恢复正常,16例)、2组(51~95分,部分恢复,34例)、3组(≤50分,恢复差,18例),采用方差分析、Pearson和Spearman相关分析,分析脑梗死区FA值及CST受累程度与运动功能恢复的关系。结果发病7 d内和3个月时3组FA的变化幅度[(0.05±0.06、0.08±0.07、0.18±0.02)、(0.11±0.02、0.21±0.06、0.39±0.03)]差异有统计学意义(7 d内F=32.821,3个月时F=192.372,均P0.05)。DTT显示CST病变侧表现为受压、变形、移位和中断。发病7 d内CST等级与患者肢体肌力呈负相关(r=-0.682,P0.01),3个月复查CST等级与患者肢体肌力呈负相关(r=-0.728,P0.01)。结论脑梗死患者梗死区FA值降低及CST受累程度均与运动功能预后有关。MR DTT能直观显示CST受累程度,可为早期判断脑梗死预后提供重要依据。
[Abstract]:Objective to evaluate the relationship between the damage degree of the corticospinal tract (CST) and the prognosis of motor function in patients with cerebral infarction by magnetic resonance diffusion tensor imaging (DTI) and diffusion tensor fiber beam imaging (DTT). Methods 68 patients with cerebral infarction were prospectively included, routine MRI, DWI, DTI examination were performed, and DTT technique was used to reconstruct the CST, within 7 d and 3 cases. The white matter anisotropy fraction (FA) in the cerebral infarction area and the corresponding region was measured at month time. The Fugl-Meyer scale was used to score the movement function, and the degree of CST involvement was divided into 4 levels. The patients were divided into 1 groups according to the Fugl-Meyer score after treatment (96~99, roughly normal, 16 cases), and the 2 groups (51~95, partial recovery, 34 cases), and the 3 groups (< < 50 points, poor recovery). 18 cases), using variance analysis, Pearson and Spearman correlation analysis, the relationship between the FA value of cerebral infarction and the degree of CST involvement and the recovery of motor function was analyzed. Results the range of changes of FA in the 3 groups (0.05 + 0.06,0.08 + 0.07,0.18 + 0.02) and (0.11 + 0.02,0.21 + 0.06,0.39 + 0.03) in the 7 d and 3 months was statistically significant (7 d within F=32.821,3). At month F=192.372, P0.05).DTT showed that the CST lesion side showed compression, deformation, displacement and interruption. The CST grade in 7 d was negatively correlated with the patient's limb muscle strength (r=-0.682, P0.01), and the 3 month reexamination CST grade was negatively correlated with the patient's limb muscle strength (r=-0.728, P0.01). .MR DTT can directly display the degree of CST involvement and provide an important basis for early judgement of prognosis of cerebral infarction.

【作者单位】：河南省商丘市第一人民医院神经内科;
【分类号】：R743.3;R445.2

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