磁共振扩散张量成像显示视放射区脑梗死的纤维束改变  

The application of mr dti in cerebra infarction of optic radiation

作　　者：张红[1] 李传亭[1] 刘传梅 杜燕飞[1] 郑修竹[1] 惠毅毅 

机构地区：[1]山东大学山东省医学影像学研究所,山东济南250021 [2]山东省中医医院 [3]山东省省立医院

出　　处：《实用放射学杂志》2014年第5期730-732,739,共4页Journal of Practical Radiology

摘　　要：目的：利用弥散扩散张量成像不同成像参数研究枕颞叶视放射区脑梗死纤维束的变化,追踪预后并判断转归。方法视觉障碍的50例脑梗死患者行常规磁共振检查、弥散加权成像及弥散扩散张量成像,显示视放射的纤维束走行,并测量双侧视放射梗死区域的各向异性（fractional anisotropy,FA）值、表观扩散系数（apparent diffusion coefficient,ADC）值、各向同性（isotropic im-age,Iso）值及 T2-weighted trace 值。结果颞枕叶视放射梗死区及对侧正常区测量得出各参数值的变化,FA 值在超急性期略升高,其余各期有不同程度的减低,ADC 值在超急性期、急性期和亚急性期不同程度升高,慢性期减低；Iso 和 T2-weighted trace 在急性期不同程度升高,慢性期减低。弥散扩散张量纤维束成像（diffusion tensor tractography,DTT）可以显示纤维束走行及改变；患者治疗后视力不同程度恢复。结论弥散扩散张量成像（diffusion tensor imaging,DTI）能很好地显示视觉通路中白质纤维束的走行,并显示出视放射部位梗死区纤维束破坏程度,利于判断患者预后。Objective To evaluate the fiber altering and clinical relationship in patients with occipital and temporal lobe cerebral infarction with DTI.Methods Fifty patients suffering from cerebral stroke were analyzed with conventional MRI,DWI and DTI. The fibers of visual pathway were depicted ,and their fractional anisotropy （FA）,apparent diffusion coefficient （ADC）,isotropic im-age （Iso）and T2-weighted trace were measured and analyzed.Results Regions of interest （ROIs）were placed in infarction and nor-mal contralateral tissue for tracking the visual pathways.The different parameters were measured.FA is useful to differentiate hy-per-acute stroke from acute and sub-acute stroke.FA values increased slightly in hyper-acute and decreased in acute,sub-acute and chronic phase.The values of ADC in infarction regions in hyper-acute,acute and sub-acute phases were lower than those of the con-tralateral tissue.Iso and T2-weighted trace increased in acute phase and decreased in chronic phase.DTT was used to show the way and chang of visual pathway.Conclusion DTI could track the fiber of visual pathway,and depict the fiber of infarction zone.DTT could be used in evaluating the prognosis of patients.

关 键 词：弥散扩散张量成像 视放射 脑梗死 视觉通路 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.33[医药卫生—诊断学]