纹状体内囊梗死上肢运动功能损害大脑脚弥散张量成像研究  

Diffusion tensor imaging of cerebral peduncle of striatocapsular infarction patients with upper limb motor functional lesion

作　　者：王润榕[1] 张帅[1] 周龙江[1] 谭政帅[1] 何玲[1] 李澄[1] 

机构地区：[1]扬州市第一人民医院影像科,江苏扬州225001

出　　处：《生物医学工程与临床》2014年第5期435-438,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的应用弥散张量成像（DTI）技术研究纹状体内囊梗死患者大脑脚扩散改变情况，分析其与上肢运动功能损害的关系。方法选择急性起病的缺血性脑卒中患者15例，其中男性8例，女性7例；年龄47～80岁，平均年龄62.6岁。平均受教育年限9.7年。MRI诊断为单侧上肢运动功能损害的纹状体内囊梗死。于发病后2周时行DTI,测量两侧大脑脚的各向异性分数（FA）、平均扩散率（MD）值，计算两侧FA的不对称指数（AI），对AI和受累上肢的FM功能评分进行相关分析。结果发病后2周时患侧大脑脚FA值较健侧降低（0.66±0.08 vs 0.73±0.06，P=0.02）；两侧MD值差异无统计学意义（0.92±0.11 vs0.94±0.09，P=0.51）；AI与受累上肢的FM评分呈显著负相关（r=-0.95，P〈0.01）。结论DTI可以早期检测到纹状体内囊梗死患者大脑脚的扩散变化,大脑脚部位锥体束的完整性与受累上肢的运动功能关系密切,DTI检查可以为纹状体内蠹梗死的临床评估提供量化的影像学参考．Objective To study the diffusion changes in cerebral peduncle after striatocapsular infarction by diffusion tensor imaging（DTI）, and explore its relationship with upper limb motor functional lesion. Methods A total of 15 patients with unilateral upper limb motor functional lesion after acute striatocapsular infarction for the first time were enrolled, which included 8 males and 7 females, aged 47 - 80 years old with mean age of 62.6, and mean schooling of 9.7 years. All of them were diagnosed with striatocapsular infarction with unilateral upper extremity motor function impairment by MRI. All cases were performed with DTI scan 2 weeks after onset to measure the fractional anisotropy（FA） and mean diffusivity（MD） of bilateral cerebral peduncle. The asymmetry index（AI） of FA of 2 sides was computed, and the correlation of AI with FM scores of the involved upper limb was analyzed. Results The FA of the affected side cerebral peduncle decreased significantly as compared with that of the unaffected side（0.66 ＋ 0.08 vs 0.73 ± 0.06, P= 0.02） and the MD of 2 sides was similar（0.92 ± 0.11 vs 0.94 ± 0.09, P= 0.51） at 2-week after onset. There was significantly negative correlation between AI and FM scores of the involved upper limb（r = - 0.95, P 〈 0.01）. Conclusion It is demonstrated that DTI could detect early diffusion changes in cerebral peduncle after striatocapsular infarction. The integrity of pyramidal tract in cerebral peduncle and the motor function of involved upper limb are closely related. DTI could provide quantitative imageology reference for clinical assessment of striatocapsular infarction.

关 键 词：纹状体内囊梗死 扩散张量成像 上肢运动功能 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]