fMRI及DTI技术联合应用对脑出血患者神经功能的评定  

A Combined Use of fMRI and DTI in Patients with Intracerebral Hemorrhage

作　　者：殷小平[1] 张曼青[1] 王苇[2] 

机构地区：[1]九江学院附属医院神经内科,江西九江332001 [2]东南大学附属扬州市第一人民医院影像科,江苏扬州225001

出　　处：《神经损伤与功能重建》2008年第1期31-34,共4页Neural Injury and Functional Reconstruction

基　　金：江西省科技厅社会发展攻关项目(赣科发计字[2006]185号);江西省教育厅课题([2007]333号);九江学院课题(06-kj16)

摘　　要：目的:观察基底核区脑出血患者神经纤维束方向性及完整性的变化,并在恢复期结合功能磁共振(fMRI),探讨患者运动功能损伤与神经纤维完整性之间的关系。方法:21例基底核区脑出血患者随机分为2组,分别行单纯药物治疗(药物组)和颅内血肿微创穿刺清除术(手术组),于2周内(急性期)及恢复期以张量弥散成像(DTI)检测皮质脊髓束的损伤程度、以fMRI检测恢复期运动皮层的激活范围与强度,并分析其与恢复期运动功能障碍评分的相关性。结果:急性期BI评分2组没有统计学差异(P=0.2905),恢复期2组也无统计学差异(P=0.6018)。多元方差分析急性期与恢复期BI评分有统计学差异(R=0.89862,P=0.0002)。锥体束的损害程度与BI评分间的相关系数为0.764(P=0.0001)。结论:脑出血患者锥体束的完整性与运动功能恢复情况有良好相关性,联合应用DTI、fMRI能够早期检测皮质脊髓束的损伤程度,评估预后。Objective：To observe the changes of directionality and integrity of neurofibra tracts in patients with intracerebral hemorrhage （ICH） and to explore the relationship between motor dysfunction and integrity of neurofibras Methods：Twenty-one patients with ICH were randomly divided into groups drug and surgery . Injury extent of the corticospinal tracts in patients was detected by Diffusion Tensor Imaging （DTI）,and activating extent of the tracts was detected by fMRI in acute and recovery phases. The association of the motor dysfunction in recovery phase with the injury degree of the corticospinal tracts has been analyzed. Results： There was no differences in BI scores of two groups in acute and recovery phases （P= 0. 2905, P= 0. 6018）. However, there was a significant difference between acute phase and convalescence in each groups （R=0. 89862 ,P=0. 0002）by multivariate analysis of variance. The coefficient correlation between the degree of injury of the corticospinal tracts and BI score was 0. 764 （P=0. 0001） in recovery phase. Conclusion：There was correlation between the the recovery of motor function and the integrity of the tracts. The combined use of DTI and fMRI could detect the injury degree of the corticospinal tracts and predicate the prognosis to some extent.

关 键 词：脑出血 DTI FMRI 皮质脊髓束 

分 类 号：R741[医药卫生—神经病学与精神病学] R743.34[医药卫生—临床医学]