磁共振弥散张量及纤维束成像在急性脑梗死的临床应用  

The clinical application of DTI and DTT on acute cerebral infarction

作　　者：鲍莎莎[1] 刘青蕊[1] 张金峰[2] 高秋爽[1] 孙轶飞 

机构地区：[1]河北医科大学第四医院神经内科,石家庄050011 [2]石家庄市第一医院

出　　处：《脑与神经疾病杂志》2009年第3期204-206,共3页Journal of Brain and Nervous Diseases

摘　　要：目的探讨急性脑梗死病人梗死灶弥散张量的参数变化及对皮质脊髓束的影响,以早期判断病情、评估预后。方法急性脑梗死患者45例,入院及治疗后分别行NIHSS评分记为NIHSS1、NIHSS2,常规MRI、DWI、DTI/DTT检查,分析病灶FA值的变化及与皮质脊髓束的关系。结果①梗死灶FA值降低百分比和NIHSS1相关(r=0.411,P<0.01)。②45例患者中,皮质脊髓束完整(1级)者15例,病灶致使皮质脊髓束受压、移位(2级)者20例,皮质脊髓束中断(3级)者10例。皮质脊髓束的损伤程度与NIHSS2相关(r=0.894,P<0.01)。结论病灶FA值下降越明显,患者病情越重;皮质脊髓束破坏越严重,患者运动功能受损越重,预后越差。Objective To investigate the characteristics of magnetic resonance diffusion tensor imaging（DTI） and the relationship between infracted and cortical spinal tract（CST） in patients with acute cerebral infarction in order to assess prognosis. Methods Conventional magnetic resonance imaging（MRI） and diffusion weighted imaging （DWI）、DTI/ diffusion tensor tractography（DTT） were performed on 45 patients with acute cerebral infarction. The decreasing percentage of fractional anistrophy（FA） value in infarcted were computed. Displacement, continuity and injured condition of CST were observed. At the same time, the patients were measured NIHSS. Results ①The decreasing percentage of FA value in infarcted has significant positive correlation with NIHSS1（r=0.411,P〈0.01）.②There were 15 cases whose CST were complete,20 cases whose CST were complete but compression shift,10 cases whose CST were break. The injured degree of CST has significant positive correlation with NIHSS2（r=0.894,P〈0.01）.Conclusion The larger the decreasing percentage of FA is, the more serious the clinical manifestation is. The patients with injured CST would have more serious damage of the neuromotor function and worse functional rehabilitation.

关 键 词：急性脑梗死 弥散张量成像 纤维束成像 临床预后 

分 类 号：R743.32[医药卫生—神经病学与精神病学]