弥散张量成像在高血压脑出血患者手运动功能障碍评估中的应用价值  

Application value of diffusion tensor imaging in evaluating hand motor dysfunction in patients with hypertensive intracranial hemorrhage

作　　者：贡志刚[1] 张荣俊[1] 蒋文斌[1] 付志辉[2] 

机构地区：[1]南京中医药大学苏州附属医院神经外科,江苏省215009 [2]南京中医药大学苏州附属医院放射科,江苏省215009

出　　处：《江苏医药》2016年第22期2432-2434,F0002,共4页Jiangsu Medical Journal

基　　金：江苏省第四期"333工程"科研资助项目(BRA2014090);江苏省中医药科技项目(LB11022);苏州市科技发展计划项目(SYSD2011154)

摘　　要：目的探讨弥散张量成像(DTI)技术在高血压脑出血患者手运动功能障碍评估中的应用价值。方法采用DTI技术三维重建75例高血压脑出血患者中央前回手结区域的皮质脊髓束(CST)纤维,分析CST受损情况与康复治疗前后患侧Brunnstrom手评分之间的关系。观察不同CST受损情况下,手运动功能恢复程度的差异。结果 CST受损程度与DTI检查时的Brunnstrom手评分呈负相关(rs=-0.77,P<0.01),并且与3个月后的Brunnstrom手评分也呈负相关(rs=-0.75,P<0.01)。CST受损2级患者,康复治疗后Brunnstrom手评分高于康复治疗前的Brunnstrom手评分[(3.79±1.36)分vs.(2.53±1.58)分](P<0.05)。结论 DTI能直观反映中央前回手运动功能相关CST纤维受损情况,可用于预测康复治疗的效果。Objective To study the appilication value of diffusion tensor imaging （DTI） in the evaluation of hand motor dysfunction in the patients with hypertensive intracranial hemorrhage. Methods Corticospinal tract（CST）fibers from precentral knobs were three- dimentionally reconstructed by DTI technique in 75 patients with hypertensive intracranial hemorrhage. Furthermore, the relationship between the damage extent of CSTs and Brunnstrom hand scores was analyzed. The differences of the recovery of hand motor function were observed among the cases with different degrees of CST fibers. Results A highly negative correlation was found between the damage extent of CST fibers and Brunnstrom hand scores at the time of DTI examination （rs =- 0.77, P〈0. 01） and between the damage extent of CST fibers and Brunnstrom hand scores in 3 months after rehabilitation therapy（rs =- 0. 75, P〈0. 01）. The Brunnstrom hand score in the cases with CST damage of grade 2 was higher in 3 months after rehabilitation therapy than before[（3.79± 1.36） points vs. （2.53±1.58） points]（P〈0. 05）. Conclusion DTI can intuitively show the damage extent of CST fibers from the precentral gyrus closely related to the hand motor dysfunction in the patients with hypertensive intracranial hemorrhage, in whom DTI technique may be taken as an indicator for predicting the theraputic effect of rehabilitation.

关 键 词：脑出血 弥散张量成像 皮质脊髓束 中央前回 

分 类 号：R604[医药卫生—外科学]