弥漫性轴索损伤的胼胝体DTI研究  

DTI study of corpus callosun for evaluating diffuse axonal injury

作　　者：李华[1,2] 庄贵华[2] 纪文军[2] 高燕华[3] 陈轶[2] 刘浩[2] 朱志敏[2] 

机构地区：[1]西安交通大学公共卫生学院,陕西西安710061 [2]榆林市第二医院 [3]陕西省人民医院

出　　处：《实用放射学杂志》2015年第1期8-11,69,共5页Journal of Practical Radiology

摘　　要：目的：利用磁共振扩散张量成像（DTI）技术对中重型脑损伤（TBI）患者胼胝体损伤进行量化,探讨其对早期弥漫性轴索损伤（DAI）的诊断及预后的应用价值。方法应用 T1 WI（MPRAGE 序列）和 DTI（EPI 序列）对30例中重型 TBI 患者和30例健康体检者（对照组）进行检查。进行图像后处理得到各向异性分数彩色图（FA color map）,选取胼胝体整体和膝部、胼胝体干、压部分别作为兴趣区（ROI）,测量不同 ROI 的 FA 值和表观扩散系数（ADC）值。进行组间比较,以及 TBI 组内比较。对 TBI 组胼胝体整体和分段 FA 值和 ADC 值与昏迷时间进行直线相关分析。结果与对照组相比,TBI 组胼胝体整体和膝部、胼胝体干、压部的 FA值下降,ADC 值上升,差异有统计学意义。TBI 组胼胝体整体和分段 FA 值和 ADC 值与昏迷时间密切相关。结论磁共振 DTI 技术能较敏感地检测出神经纤维的损伤,胼胝体 FA 值与 DAI 损伤程度有密切的相关性对早期诊断 DAI 和评估预后有较高的应用价值。Objective To evaluate DTI for early diagnosis and prognosis of diffuse axonal injury （DAI）in the moderate and sever traumatic brain injury （sTBI）.Methods 30 patients with sTBI and 30 healthy controls were studied with T1 WI and DTI.The frac-tional anisotropy（FA）and ADC were quantified from different regions of interest（ROI）including the genu of corpus callosum（gCC）, the trunk of CC,the splenium of CC（sCC）and the integrity CC.The FA and ADC of the same R0I was compared between TBI group and control group,and FA and ADC of the different parts of CC were compared in TBI group.Correlations between the FA or ADC and coma duration of the TBI patients were analyzed by Pearson linear correlation.Results Compared with control group,the FA value decreased significantly in each ROI,while ADC was reversed.The FA or ADC of the different ROI were correlated with co-ma duration in TBI group.Conclusion DTI is sensitive to detect the white matter injury of TBI.FA value detected in the CC can help diagnose DAI earlier and evaluate the degree of injury.

关 键 词：弥漫性轴索损伤 扩散张量成像 胼胝体 磁共振成像 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]