卒中后皮质脊髓束Waller变性的DTI表现及其与运动功能受损的关系  

Wallerian degeneration of the corticospinal tracts on diffusion tensor imaging after stroke and its relationship with impaired motor function

作　　者：方珉[1] 谢瑞满[1] 周林江[2] 

机构地区：[1]复旦大学附属中山医院,复旦大学上海医学院,上海200032 [2]复旦大学附属华山医院,复旦大学上海医学院,上海200040

出　　处：《国际脑血管病杂志》2009年第3期205-210,共6页International Journal of Cerebrovascular Diseases

摘　　要：皮质脊髓束Waller变性是由于其上运动神经元或轴突损伤引起的远端轴突和髓鞘顺行性变性。卒中是引起皮质脊髓束Waller变性的最常见原因。皮质脊髓束Waller变性的常规MRI显示为与原发病灶相连的符合皮质脊髓束走行的条状异常信号，但常规MRI无法显示卒中发生后4周内的Waller变性。MRI弥散张量成像（diffusiontensorimaging，DTI）可早期检测皮质脊髓束Waller变性，且可动态观察从亚急性早期到慢性期的病理变化过程。文章综述了DTI在显示卒中后皮质脊髓束Waller变性，尤其是早期Waller变性中的作用，以及在卒中患者预后判断和后期康复中的价值。Wallerian degeneration of the corticospinal tracts is the anterograde degeneration of distal axons and myelin caused by the upper motor neuron injury or axonal injury. Stroke is the most common cause of Wallerian degeneration of the cortieospinal tracts. Conventional magnetic resonance imaging （MRI） of Wallerian degeneration of the corticospinal tracts is a linear abnormal signal that connects the original lesion along the corticospinal tracts, but the conventional MRI signal does not reveal Wallerian degeneration until 4 weeks after stroke. Diffusion tensor imaging （DTI） detects early Wallerian degeneration of the corticospinal tracts, and dynamically observes the process of pathological changes from early subacute stage to chronic stage. This article reviews Wallerian degeneration of the corticospinal tracts on DTI after stroke, especially the effect in early Wallerian degeneration, as well as the values in predicting prognosis and late rehabilitation in patients with stroke.

关 键 词：WALLER变性 磁共振成像 弥散 卒中 

分 类 号：R445.2[医药卫生—影像医学与核医学]