创伤性脑白质损伤的扩散张量成像研究  

A diffusion tensor imaging study of traumatic cerebral white matter injury

作　　者：杨烁慧[1] 陆方[1] 朱琼[1] 杨赛[1] 李晨[1] 杨炯[1] 詹松华[1] 

机构地区：[1]上海中医药大学附属曙光医院放射科,上海200021

出　　处：《中国中西医结合影像学杂志》2012年第3期195-197,188,共3页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:评价扩散张量成像(DTI)在创伤性脑白质损伤(WMI)中的应用价值。方法:16例创伤性脑外伤后经临床诊断有WMI的患者通过Philips 1.5TIntera Achieva MR扫描仪行常规MRI和DTI。后处理获得部分各向异性指数(FA)、表观弥散系数(ADC)和纤维示踪成像三维图。根据T2WI及T2快速场回波图像,分别于WMI区域、同侧同名或对侧同名纤维束正常区域取感兴趣区,测量FA值和ADC值并进行比较。结果:脑外伤患者损伤脑白质中挫伤和出血、仅挫伤和仅出血区域三者之间的FA值(F=0.68,P>0.05)和ADC值(F=0.53,P>0.05)均未见明显不同。除仅出血区域的ADC值与对照区域相比差异无统计学意义(t=1.36,P>0.05),挫伤和出血(t=9.72,P<0.05)、仅挫伤(t=8.28,P<0.05)和仅出血(t=5.44,P<0.05)区域的FA值较正常对照区域明显降低,挫伤和出血(t=4.71,P<0.05)、仅挫伤(t=4.81,P<0.05)的ADC值较正常对照明显增高,纤维示踪成像显示损伤区域脑白质较正常区域稀疏、分离、缺失。结论:DTI技术能够显示患者WMI区域的异常改变,但ADC值对出血的判断有局限性。Objective： To evaluate the value of diffusion tensor imaging （DTI） in traumatic cerebral white matter injury. Methods：Sixteen traumatic cerebral white matter injury patients underwent traditional MRI and DTI scans on the 1.5 T Philips Intera Achieva MR scanner. Fractional anisotropy （FA） maps,apparent diffusion coefficient （ADC） maps and diffusion tensor tracking （DTT） images were obtained. According to the T2WI and T2-FFE images,regions of interest （ROIs） were selected on the injured white matter,and control ROIs were selected on the ipsior contra-lateral homonymic white matters. The means of FA and ADC within these ROIs were compared. Results：An ANOVA analysis revealed no significant regional differences in both FA and ADC values （ P 〉0.05） in the injured white matter. Moreover,except ADC values of the hemorrhagic foci showing no difference compared with the control ROIs（ t = 1.36, P 〉0.05）, significantly lower FA values of the foci of contusion with hemorrhage （ t =9.72, P 〈0.05） ,the contusion foci （ t =8.28, P 〈0.05） and the hemorrhagic foci（ t ：5.44, P 〈0.05） ,higher ADC values of the foci of contusion with hemorrhage（ t =4.71, P 〈0.05）and the contusion loci（ t =4.81, P 〈0.05）were seen in the injured white matter compared to the controls. DTT images showed the injured white matter were sparse, separated,and lost. Conclusion：Our results suggest that abnormalities in the white matter of the traumatic cerebral injury patients can be detected by using DTI metrics. However,there has the limitation of ADC values in the hemorrhagic foci.

关 键 词：扩散张量成像 脑损伤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R651.15[医药卫生—诊断学]