弥散张量成像对基底节区脑出血致皮质脊髓束损伤转归评估

发布时间：2018-06-22 22:29

本文选题：脑出血 + 锥体束　；参考：《中国临床医学影像杂志》2015年05期

【摘要】：目的:探讨弥散张量成像(DTI)评估基底节区脑出血致皮质脊髓束(CST)损伤转归的可行性。方法:对36例基底节区脑出血患者于发病8~15天及4~6月内行3.0T MR常规及DTI检查,基于感兴趣区(ROI)测量患侧及对侧大脑脚区的平均FA值(FA)。依据DTT图患侧CST受损程度分为A型(CST受压移位)、B型(CST部分中断)和C型(CST完全中断)。比较患侧及对侧大脑脚区FA值的差异性,并分别比较两次检查患侧大脑脚FA值的差异性及对侧大脑脚FA值的差异。分析A型、B型及C型大脑脚区r FA值(患侧FA值/对侧FA值)与随访改良RANKIN量表(m RS)及功能独立性评定运动评分(FIMm)的相关性。结果:8~15天DTI示C型m RS评分明显差于A型及B型(t=-11.731,P0.05;t=-2.618,P0.05);A型的m RS评分优于B型(t=-5.965,P0.05)。4~6月DTT示A型16例中2例转化为B型,14例没有变化。B型12例中,11例转化为A型,1例转化为C型;C型8例中,2例转化为A型,1例转化为B型,另5例没有变化。比较两次检查两侧大脑脚区FA值,差异均有显著统计学意义(t=-9.054,P0.05;t=-7.962,P0.05);比较两次检查患侧大脑脚FA值,差异有统计学意义(t=-3.511,P0.05);比较两次检查对侧大脑脚FA值,差异有统计学意义(t=-2.252,P0.05);两次检查大脑脚区r FA值与随访m RS评分有相关性(r=-0.803,P0.05;r=-0.654,P0.05),与随访FIMm评分均无相关性(r=0.288,P0.05;r=0.174,P0.05)。其中,第一次检查A型大脑脚r FA值与FIMm评分弱相关性(r=0.499,P0.05);B型大脑脚r FA值与随访m RS评分有相关性(r=-0.875,P0.05)。第二次检查A型大脑脚r FA值与随访m RS评分有相关性(r=-0.783,P0.05)。结论:在基底节脑出血中,大脑脚区r FA值能评估脑出血远期神经运动功能预后,DTI成像能定量评估CST损伤转归及重塑。
[Abstract]:Objective: to evaluate the feasibility of diffuse Zhang Liang imaging in evaluating corticospinal tract injury caused by basal ganglia hemorrhage. Methods: 36 patients with basal ganglia intracerebral hemorrhage were examined with 3. 0T Mr routine and DTI within 815 days and 4 ~ 6 months after onset. The mean FA value (FA) of the affected and contralateral cerebral feet was measured based on ROI. According to the degree of CST damage in the affected side of DTT, there were two types: type A (compression shift of CST), type B (partial interruption of CST) and type C (complete interruption of CST). To compare the difference of FA between the affected and contralateral cerebral feet, and to compare the difference of FA between the affected and contralateral cerebral feet. To analyze the correlation between the r FA value of type A, B type and C type of cerebral foot area (FA / contralateral FA) and the modified RANKIN scale (Mrs) and the motor score (FIMM) of functional independence assessment. Results the MRS score of type C was significantly lower than that of type A and type B (tnc-11.731U, P0.05TU -2.618p0.05). The MRS score of type A was better than that of type B (tn-5.965p0.05). From April to June, DTT showed that 2 of 16 cases of type A were transformed into type B, and 11 of 12 cases of type B were transformed into type A. 11 of 12 cases of type B showed no change. Among the 8 cases of type C, 2 cases were transformed into type A and 1 case was transformed into type B. The other 5 cases had no change. There were statistically significant differences in FA values of bilateral cerebral foot regions between two examinations (tnm9.054, P0.05T- 7.962p0.05), and there were significant differences in FA values of the affected cerebral feet between the two examinations (t-3.511p0.05), and the FA values of contralateral cerebrum by two examinations (tnm9.054g, P0.0552p0.05), the difference between the two examinations was statistically significant (t-3.511p0.05), and the difference between the two examinations was statistically significant. The difference was statistically significant (t = 2.252, P 0.05), the rFA value of the cerebral foot area was correlated with the following up Mrs score (r = 0.803, P 0.05, P 0.05, P = 0.654), but had no correlation with the follow-up FIMm score (r = 0.288, P = 0.05, P = 0.174, P < 0.05). For the first time, there was a weak correlation between type A cerebral foot r FA value and FIMm score (r 0. 499U P 0.05). There was a correlation between r FA value of B type cerebral foot and follow-up Mrs score (r 0 875% P 0.05). There was a correlation between the rFA value of type A cerebral foot and the follow-up Mrs score (r = -0.783P 0.05). Conclusion: in basal ganglia hemorrhage (BGH), the rFA value of cerebral foot area can evaluate the prognosis of neurological motor function in patients with intracerebral hemorrhage. DTI imaging can quantitatively evaluate the prognosis and remodeling of CST injury.
【作者单位】：南京医科大学附属南京医院医学影像科;南京医科大学附属淮安第一医院医学影像科;
【分类号】：R743.34;R445.2

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