基于扩散张量成像的高血压脑出血患者皮质脊髓束损伤的研究  

Diffusion tensor imaging study of corticospinal tract injury in patients with hypertensive intracerebral hemorrhage

作　　者：张华文[1,2] 闫新成[2] 闵志刚[2] 李敏[2] 张明[2] 

机构地区：[1]陕西省核工业二一五医院影像科,陕西咸阳712000 [2]西安交通大学医学院第一附属医院影像科

出　　处：《实用放射学杂志》2013年第12期1901-1905,共5页Journal of Practical Radiology

基　　金：陕西省科技攻关资助项目（2012K16-08-13）.

摘　　要：目的应用磁共振扩散张量成像（DTI）技术，观察高血压脑出血（HICH）患者皮质脊髓束（CST）各向异性的变化，探讨其与神经功能的关系。方法列25例HICH患者手术前/后行DTI检查，测量并比较健侧和患侧对应部位内囊后肢的部分各向异性（FA）值,同时采脂NIHSS量表行神经功能缺损评分，分析FA值降低百分比与NIHSS评分之间的相关性。结果（1）2组健侧及患侧CST区FA值前后比较差异无统计学意义；2组患侧CST区FA值与同期健侧比较差异有显著性意义（P〈0．001）；（2）2组患侧CST区FA值降低百分比与同期NIHSS评分之间呈正相父关系（P〈0．01）；（3）术后患侧CST区FA值上升幅度与NIHSS评分恢复之间呈正相关关系（P〈0．01）。结论DTI能够定量评价HICH患者脑白质的损伤情况，并反映神经功能的恢复程度，为临床下术选择和预后评估提供一定的依据。Objective To observe changes of fractional anisotropy （FA） of corticospinal tract （CST} in patients with hypertensive intracerebral hemorrhage （HICH） using magnetic resonance diffusion tensor imaging （DTI）, and explore its relationship with neuro logic function. Methods DTI was performed in 25 patients with H1CH before and after surgery. FA values of the bilateral posterior limb of internal capsule （PLIC） were measured and compared. NIHSS scale was used to evaluate the neurologic defect, and then re- lationship of percent reduction of FA value and NIHSS score was analyzed. Results （1）Pre and post-operative FA value of CST was different but no statistically significant difference; FA value of the affected CST was significantly lower than that of the controlateral CST before and after surgery （P〈0. 001）, respectively. （2）The percent reduction of FA value of the affected CST was positive correlation with NIHSS score before and after surgery （P〈0.01）, respectively. （3）The postoperative percent increase of FA valueof the affected CST was positive correlation with NIHSS score recovery （P〈0. 01）. Conclusion In patients with HICH, DTI can be used to quantitatively evaluate the injury of CST, reflect the recovery of neurologic function, and provide a basis for surgical options and prognostic assessment.

关 键 词：高血压脑出血 皮质脊髓束 部分各向异性 扩散张量成像 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]