磁共振扩散张量成像在评价高血压性壳核出血视辐射损伤中的应用研究  

Applied research of DTI in evaluating optic radiation injury in hypertensive putaminal hemorrhage

作　　者：侯小林[1,2] 杨东东 李定君[1] 李成勋[1] 曾林[1] 顾应江 Hou Xiaolin;Yang Dongdong;Li Dingjun;Li Chengxun;Zeng Lint;Gu Yingjiang(Department of Neurosurgery;Department of Neurology;Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610072,Chin;3.Clinical Medical Colloge,Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 611137,Chin;4.Department of Neurosurgery,Affiliated Hospital of TCM,Southwest Medicine University,Luzhou,Sichuan 646000,China)

机构地区：[1]成都中医药大学附属医院神经外科,610072 [2]成都中医药大学临床医学院,611137 [3]成都中医药大学附属医院神经内科,610072 [4]西南医科大学附属中医院,泸州646000

出　　处：《中国微侵袭神经外科杂志》2018年第9期397-400,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的研究磁共振扩散张量成像(DTI)在判断高血压性壳核出血视辐射(OR)损伤中的作用。方法纳入36例经保守治疗的高血压性壳核出血病人作为脑出血组,并选取30例健康成人(志愿者)作为对照组,均行DTI检查,重建双侧OR,将OR损伤类型分为Ⅰ、Ⅱ、Ⅲ型,测定OR-FA值、OR-ADC值,并对检测数据进行统计学分析。结果对照组左、右两侧ORFA值、OR-ADC值差异无统计学意义(P>0.05)。脑出血组病侧与健侧OR-FA值、OR-ADC值差异显著(P<0.05),病侧OR明显受损;血肿体积与病侧OR-FA值、OR-ADC值均不相关(P>0.05)。脑出血组OR损伤Ⅰ、Ⅱ、Ⅲ型分别为10、12、14例,3种损伤类型间OR-FA值、OR-ADC值差异有统计学意义(P<0.05);与发病3~5 d时比较,3个月后复查OR-FA值明显升高,OR-ADC值明显下降(P<0.05),病人OR损伤情况明显改善。结论高血压性壳核出血OR损伤率高,血肿体积与OR损伤程度无关,DTI可观察血肿与OR三维关系,判断OR受损程度,对评估病人视野缺损有重要价值。Objective To study the role of DTI in evaluating optic radiation（OR） injury in hypertensive putaminal hemorrhage（HPH）.Methods Thirty-six HPH patients were brought into the research as HPH group and 30 normal healthy volunteers as control group.DTI examination was performed in all the patients and volunteers, and the bilateral OR was reconstructed. Then, the injury severity of ORs were divided into type Ⅰ, Ⅱ and Ⅲ, the fractional anisotropies（FA） and apparent diffusion coefficient（ADC） values of OR were measured, and the measuring data were analyzed statistically. Results There were no significant differences in OR-FA and OR-ADC values between left side and right side in the control group（P 0.05）, while significant differences in OR-FA and OR-ADC values were found between injured side and uninjured side in the HPH group（P 0.05）, and the injured side was obviously damaged.However, no correlation was found between hematoma volume and OR-FA value or OR-ADC value in injured side（P 0.05）. The type Ⅰ, Ⅱ, Ⅲ of OR injury were seen in 10, 12, 14 patients respectively, and there were significant differences in OR-FA and OR-ADC values between the three types in HPH group（P 0.05）. Compared with 3 to 5 days after onset of illness, the OR-FA value increased significantly and OR-ADC value decreased significantly（ P 0. 05）, and the OR injury severity improved obviously.Conclusions There is a high injury rate of OR in HPH, and no correlation is found between hematoma volume and OR injury severity.Otherwise, DTI can observe the 3 D relationship between hematoma and OR, judge the OR injury severity, and have important value in evaluating the visual field defect of patients.

关 键 词：颅内出血 高血压性 壳核 视辐射 扩散张量成像 视野缺损 

分 类 号：R743.34[医药卫生—神经病学与精神病学]