动态观察脑出血后锥体束继发性损害的弥散张量成像研究  

Investigation on the secondary degeneration of pyramidal tracts after cerebral hemorrhage with diffusion tensor imaging

作　　者：李胜愉 梁志坚[2] 王进[2] 黄彩球 蒙喜斯 戴旖[2] 叶伟[2] 曾莉梅 崔伟 李秋明 

机构地区：[1]广西武鸣县人民医院神经内科,广西武鸣530100 [2]广西医科大学第一附属医院神经内科,广西南宁530021

出　　处：《右江民族医学院学报》2013年第3期265-268,共4页Journal of Youjiang Medical University for Nationalities

基　　金：国家自然科学基金(编号:30860088);广西自然科学基金(编号:0832134);广西研究生教育创新计划项目(309133)

摘　　要：目的应用磁共振成像(MRI)的弥散张量成像(diffusion tensor imaging,DTI)技术,研究和探讨脑出血后锥体束继发性损害的发生发展规律及其临床意义。方法连续收录2010年7月～2013年1月住院治疗且脑出血患者12例为实验组和选择性别、年龄与实验组相匹配的健康志愿者12例做为对照研究。分别进行DTI检查,实验组和对照组DTI数据采用t检验;各个时间点数据之间的两两比较用LSD方差分析法。结果所有实验组患者在DTI的FA图上,同侧病灶锥体束平面上,均可见信号减弱。FA值与对照组比较,各时间点明显减少(P<0.01),而MD值却无明显变化。结论 DTI不仅可以以可见的图像清楚地显示脑出血后锥体束继发性损害,还可以用数据的形式精确量化这种损害的程度,并发现继发性损害会随时间延长而逐渐加重,有可能阻碍患者的神经功能恢复。Objective To idal tracts （PT） imaging （MRI） after cerebral and diffusion explore the occurrence and development of the secondary degeneration of pyramhemorrhage and its clinical significance by using conventional magnetic resonance tensor imaging （DTI） techniques. Methods Twelve patients with cerebral hemorrhage admitted to our hospital from Jul. 2010 to Jan. 2013 were enrolled in the experimental group. All the patients underwent conventional MRI and DTI. Twelve age-- and gender-- matched volunteers underwent DTI at the same time were selected as controls. Mean diffusivity （MD） and fractional anisotropy （FA） were measured at the region of interest （ROI）. t test was used to perform comparison of DTI data （FA values） be- tween experimental group and control group. Repeat measurement was established to reveal the time course of clinical scores and DTI quantitative data. Used LSD analysis of variance to perform comparison between group means at each time points. Results In DTI scanning, on the map of FA, intensive signal decreased in the PT of the ipsilateral cerebrum in all cases of experimental group. Compared to control group, patients of experimental group in FA values of lesion site at every time points, the ipsilateral proximal significantly decreased （ P 〈0.01）, while the MD was not significantly different at any time points. Conclusion The secondary degeneration of PT after cerebral hemorrhage can be revealed on MRI, DTI not only can demonstrate it clearly with the map of FA, but also can identify and quantify the secondary degeneration with the precise data of the FA value. Our findings indicated that the secondary degeneration is more serious as disease prolonged, which may hamper the neurological recovery.

关 键 词：脑出血 继发性损害 磁共振成像 弥散张量成像 

分 类 号：R743.34[医药卫生—神经病学与精神病学]