磁共振张量成像对脑梗死预后的评价  

Diffusion tensor imaging and MR tractography techniques in prognostic evaluation of patients with cerebral infarction

作　　者：许祖梅[1] 郭庆清[1] 陈国章[2] 李梅芳[1] 林鹏星[2] 

机构地区：[1]福建莆田学院附属医院医学影像科,莆田351100 [2]福建莆田学院附属医院神经内科,莆田351100

出　　处：《中国实用神经疾病杂志》2008年第12期4-6,共3页Chinese Journal of Practical Nervous Diseases

基　　金：福建省自然科学基金资助项目(2007J0374)

摘　　要：目的利用磁共振弥散张量成像(DTI)探讨脑梗死病人脑白质纤维束各向异性特征和白质纤维束受损与临床预后关系。方法对23例脑梗死患者行DTI检查,以三维立体弥散张量成像为基础的色彩图进行图像后处理,评价脑梗死区周边纤维束的情况,将纤维束分为受压移位、变细萎缩和破坏中断三类,并与临床预后、神经功能缺损程度比较。结果三维成像所见与病人预后关系密切。所有脑白质纤维束萎缩和中断的患者,在随访过程中存在不同程度脑功能损伤,而脑白质受压移位的病人神经功能完全或近乎完全恢复。结论在脑梗死中,DTI能直接观察到白质纤维束的变化,对于评估临床预后具有重要作用。Objective To study the diffusion anisotropie features of white matter fibers of cerebral infarction patients by MR diffusion tensor imaging （DTI）,and to evaluate the relationship between the impairment degree of white matter tracts and clinical recovery. Methods Diffusion tensor imaging data were acquired in 23 cases of cerebral infarction on a 1.5T MR imaging scanner, with three-dimensional diffusion tensor imaging-based colour maps and MR tractography performed offline. We evaluated the spatial relationships of the eloquent white matter tracts to the infarcts and areas of haemorrhage, and classified them with the tracts as displaced, thinned and disrupted . We compared these with the severity of the neurological deficits and prognosis. Results A close correlation was found between tractography findings and clinical recovery. All the patients with disruption of white matter tracts had residual deficits on clinical follow-up, whereas the patients with displaced tracts had nearly complete neurological recovery. Conclusion Diffusion tensor imaging provides a novel and useful method to directly visualize changes in the white matter tracts in cerebral infarction. It can potentially allow clinical imaging correlation with prognostic potential.

关 键 词：脑梗死 弥散张量成像 纤维束成像 磁共振成像 

分 类 号：R743.33[医药卫生—神经病学与精神病学]