弥散张量成像技术对急性脑梗死患者的皮质脊髓束行三维重建的临床价值  

The clinical value of implementing 3D reconstruction on corticospinal tract of patients with acute cerebral infarction by DTI technique

作　　者：盛杰鑫 黄光建[1] 王波[1] 杨超[1] 王萌[1] SHENG Jie-xin;HUANG Guang-jian;WANG Bo(Department of Medical Imaging Diagnosis,Hanzhong Central Hospital,Hanzhong 723000,China)

机构地区：[1]汉中市中心医院医学影像诊断科,陕西汉中723000

出　　处：《中国医学装备》2018年第10期55-58,共4页China Medical Equipment

摘　　要：目的:探讨弥散张量成像(DTI)技术对急性脑梗死患者的皮质脊髓束(CST)进行三维重建的临床价值。方法:选取在医院治疗的54例急性脑梗死患者,均进行DTI检查,对CST进行三维重建,评价CST受累情况。采用改良Barthel指数(MBI)评价患者治疗后日常生活活动能力(ADL)。结果:患侧白质平均扩散系数(DCavg)、部分各向异性系数(FA)、相对各向异性系数(RA)和容积比(I-VR)分别为(0.350±0.112)×10^(-3)mm^2/s、(0.412±0.124)、(0.230±0.064)和(0.125±0.024),明显低于健侧白质,其差异有统计学意义(t=-18.265,t=-4.270,t=-19.630,t=-42.518;P<0.05);CST受累分级3级患者患侧白质DCavg、FA、RA和I-VR分别为(0.303±0.105)×10^(-3)mm^2/s、(0.364±0.112)、(0.201±0.070)和(0.114±0.031),明显低于CST受累分级1级和2级患者,其差异有统计学意义(F=12.034,F=11.816,F=9.146,F=7.224;P<0.05);CST受累分级3级患者治疗后4周ADL评分明显低于CST受累分级1级和2级患者评分,3个不同CST受累分级ADL评分比较,差异有统计学意义(F=243.164,P<0.05);CST受累分级与ADL评分呈负相关(r=-0.304,P<0.05)。结论:DTI对急性脑梗死患者的CST进行三维重建,可清晰观察梗死病灶对CST损害,同时对患者肢体功能恢复情况的预测有一定临床价值。Objective： To investigate the clinical value of implementing three-dimensional reconstruction on corticospinal tract （CST） of patients with acute cerebral infarction by using diffusion tensor imaging （DTI） technique. Methods： Fifty-four patients with acute cerebral infarction who received treatment in the hospital were selected for DTI examination, and 3D reconstruction of CST was implemented to evaluate the involved situation of CST. The modified Barthel index （MBI） was adopted to evaluate routine activities of daily living （ADL） after patients were treated. Results： The average diffusion coefficient （DCavg） of white matter （0.350±0.112）×10-3mm2/s, partial anisotropy coefficient （FA） （0.412±0.124）, relative anisotropy coefficient （RA） （0.230±0.064） and volume ratio （I-VR） （0.125±0.024） of the affected side were significantly lower than those of health side （t=-18.265, t=-4.270, t=-19.630, t=-42.518, P〈0.05）, respectively. As the involved classification of CST, the DCavg （0.303±0.105）×10-3mm2/s, FA（0.364±0.112）, RA （0.201±0.070） and I-VR （0.114±0.031） of affected sides of patients with 3th grade were significantly lower than those of patients with 1th grade and those of patients with 2th grade （F=12.034, F=11.816, F=9.146, F=7.224, P〈0.05）. The ADL scores of patients with 3th grade post 4 weeks with treatment were significantly lower than that of patients with 1th grades and patients with 2th grade, and the differences of ADL scores among 3 different CST-affected grades were significant （F=243.164, P〈0.05）. And the involved grade of CST was negatively correlative with ADL score （r=-0.304, P〈0.05）. Conclusion： 3D-reconstruction of CST of patients with acute cerebral infarction by using DTI can clearly observe the damage of infarction lesion for CST, at the same time, it has certain clinical value in predicting the recovery of limb function of patient.

关 键 词：弥散张量成像技术 三维重建 皮质脊髓束 急性脑梗死 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]