功能磁共振成像对急性脑梗死患者预后判断的价值  

Prognostic value of functional mangnetic resonance imaging for functional recovery in acute stroke patients

作　　者：潘经锐[1] 袁芳[2] 黄小雄[1] 胡涛[3] 黄穗乔[4] 王艺东[1] 

机构地区：[1]中山大学孙逸仙纪念医院神经科,广州510120 [2]广州医学院第二附属医院神经科 [3]东莞市人民医院放射科 [4]中山大学孙逸仙纪念医院放射科

出　　处：《中国神经精神疾病杂志》2012年第10期577-581,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：广州市科技攻关重点项目(编号:2006Z1-E0111)

摘　　要：目的探讨功能磁共振成像(functional magnetic resonance imaging,fMRI)检测脑感觉运动皮质(sensorimotor cortex,SMC)区激活对于急性脑梗死患者预后的评估价值。方法对44例脑梗死患者在起病6～72 h内和14 d进行手被动运动模式的fMRI成像以及美国国立卫生院卒中量表(NIHSS)评分,在起病30 d和90 d时进行修正Barthel指数(modified Barthel index,MBI)评分和修正Rankin量表(modified Rankin scale,mRS)评分。结果 SMC激活组患者的NIHSS评分低于无激活组(6～72 h:9.5±2.1 vs 11.9±4.2,P=0.023;14 d:中位数:5 vs 10,P=0.01),脑梗死体积小于无激活组(P<0.05);14 d SMC激活组的30 d和90 d MBI、30 d mRS评分均优于无激活组(P<0.05),14 d SMC激活体积与14 d NIHSS、30 d和90 d的MBI、mRS评分值也有相关关系(P<0.05)。结论手被动运动激活SMC区的fMRI成像对急性脑梗死患者有预后评估价值,尤其起病14 d时SMC区的激活情况与患者预后密切相关。Objective To study the prognostic value of sensorimotor eortex（SMC）＇s activation for functional re- covery in acute stroke patients using functional magnetic resonance imaging （fMRI）. Methods The activation of SMC and NIHSS scores were evulated in forty-four patients with acute cerebral infarction （6 - 72 h） within 72 h of onset and at 14 d. Modified Barthel index （mBI） and Modified Rankin scale （mRS） scores were assessed at 30 and 90 d after stroke onset. Results NIHSS scores and infarction volume were lower in SMC activation group than in no-SMC-activa- tion group. Patients with SMC activation at the 144 day had better mBI and mRS scores at 30 and 90 d compared with those without SMC activation （all P 〈 0.05）. The volume of SMC at 14^th day was correlated with the scores of NIHSS at 14 d, mBI/mRS at 30 and 90 d （all P 〈 0.05）. Conclusions The activation of SMCby passive movement, especially at 14 days of stroke onset, has a prognosis value for function recovery in acute ischemic stroke patients.

关 键 词：功能磁共振成像 脑梗死 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]