弥散张量成像对意识障碍患者诊断与预后评估的作用

发布时间：2018-03-08 19:15

本文选题：弥散张量成像　切入点：意识障碍　出处：《中华神经创伤外科电子杂志》2016年06期 　论文类型：期刊论文

【摘要】：目的探讨弥散张量成像(DTI)对意识障碍(DOC)患者的临床应用价值及其各指标变化规律。方法选取自2014年1月至2015年12月陆军总医院附属八一脑科医院临床诊断为DOC的患者[植物状态(VS)患者56例,微意识状态(MCS)患者19例]进行弥散张量扫描,分别收集脑干、丘脑、皮层下三个相关的感兴趣区域评价FA、MD等指标数据。对不同意识状态的两组的参数值进行统计学分析,并将感兴趣区的各向异性(FA)、平均弥散率(MD)均值与临床昏迷恢复量表(CRS-R)评分进行相关性分析。结果 VS组FA值明显低于MCS组,差异具有统计学意义(P0.05);MD值则高于MCS组,差异具有统计学意义(P0.05);感兴趣区(脑干、皮层下,丘脑)FA值和MD值与CRS-R评分具有较好相关性,尤其是丘脑部。结论 DTI对于DOC影像学分级具有一定的临床参考价值。意识障碍程度越重,MD值越高,FA值越低。
[Abstract]:Objective to investigate the clinical application value of diffusive Zhang Liang imaging (DTI) in patients with consciousness disorder (DOC) and the change rule of each index. Methods from January 2014 to December 2015, the clinical diagnosis of DOC was performed in the Department of brain Hospital affiliated to the General Hospital of the Army. There were 56 patients with VSs. Nineteen patients with microconscious MCSs were scanned by diffusive Zhang Liang to collect data of brain stem, thalamus and subcortical regions of interest for evaluating FAMD. The parameters of the two groups were statistically analyzed. The correlation between the mean value of anisotropy and mean diffusion rate (MDR) and the clinical coma recovery scale (CRS-RV) score was analyzed. Results the FA value of vs group was significantly lower than that of MCS group, and the difference was statistically significant (P 0.05) and the MD value of MCS group was higher than that of MCS group. The difference was statistically significant (P 0.05), the area of interest (brainstem, subcortical, thalamic FA and MD) had a good correlation with CRS-R score. Conclusion DTI has certain clinical reference value for the imaging grade of DOC. The more severe the degree of disturbance of consciousness, the higher the MD value and the lower the FA value.
【作者单位】：潍坊医学院;陆军总医院附属八一脑科医院;全军军事认知与心理卫生研究中心;济宁市第一人民医院神经外科;燕山大学电气工程学院;
【基金】：全军青年基金孵育项目(15QNP006)
【分类号】：R741

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