磁共振弥散张量成像技术在轻中度脑损伤中的应用  

作　　者：潘孝根 李捷 潘海鹏 赵凯宇 劳群 

机构地区：[1]杭州市儿童医院,310002

出　　处：《浙江临床医学》2021年第5期734-736,共3页Zhejiang Clinical Medical Journal

摘　　要：[摘要]目的探讨磁共振弥散张量成像技术(DTI)在轻中度脑损伤中的应用,推断锥体束损伤的程度,并通过DTI的动态观察预测锥体束损伤后中长期的预后。方法2016年10月至2018年10月轻中度脑外伤患者25例,采用GE公司的Signa 1.5T HDX型超导型磁共振扫描仪,常规扫描方向是橫断及冠状位,DTI扫描应用自旋-平面回波技术,扫描方向为横断及冠状。采集DTI数据,额叶和额颞叶复合损伤,通过测量外伤病灶侧及非病灶侧的FA值,观察病灶远端神经束的FA值的变化。对颞叶损伤累及内囊的患者,在大脑脚水平测量病灶侧及非病灶侧FA值。结果额叶和额颞叶复合损伤患者,外伤病灶侧神经束FA值明显低于非病灶侧。测量大脑脚FA值,病灶侧神经束明显低于非病灶侧。额前叶神经束病侧FA值较健侧明显下降(0.45±0.06 vs 0.50±0.05),差异有统计学意义(P<0.05)。在大脑脚水平,病灶侧FA平均值为0.38,非病灶侧平均值为0.48,两者平均值相差0.1。在锥体束受累及的4例中,有偏侧肢体运动功能障碍。结论额前叶神经束受损,可以产生认知功能的部分缺失,受损的额前叶神经束,远端4~8周后可发生华勒氏变性,表现为T1W1等低信号,T2W1、FLAIR高信号,DWI呈等或稍高信号。通过测量远端神经束的FA值可以判定神经束受损的程度。累及锥体束的患者可以导致偏側肢体运动功能障碍。磁共振DTI技术对诊断额前叶神经束的损伤导致的认知功能部分损伤有一定的意义。Objective To moderate brain injury,infer the degree of pyramidal tract injury,and predict the mid-to-long-term prognosis of pyramidal tract injury through dynamic observation of DTI in the application of MRI diffusion tensor imaging(DTI)in mild.Methods 25 cases of mild to moderate traumatic brain injury were collected from October 2016 to October 2018,GE's Signa 1.5T HDX superconducting magnetic resonance scanner was used.The conventional scanning direction was transverse and coronal.DTI scanning was used from Spin-plane echo technology,the scanning direction was transverse and coronal.The DTI data,frontal lobe and frontotemporal lobe compound injury cases were collected,by measuring the FA value of the traumatic lesion side and the non-lesion side,observe the change of the FA value of the distal nerve bundle of the lesion.For the cases of temporal lobe injury involving the intermnal capsule,the FA values of the lesion side and the non-lesion side were measured at the level of the brain feet.Results In the case of frontal and frontotemporal complex injury,the FA value of the nerve bundle on the side of the traumatic lesion was significantly lower than that of the non-lesion side.The FA value of the brain feet was measured,the FA value of the nerve bundle on the lesion side was significantly lower than that on the non-lesion side.The FA value of the frontal tract,the lesion side and the non-lesion side showed that the FA value of the diseased side of the prefrontal nerve tract was signifcantly lower than that of the healthy side(0.45±0.06 vs 0.50±0.05),which was stistically different(t=5.15,P<0.05).At the level of the brain and feet,the average value of FA on the lesion side was 0.38,and the average value on the non-lesion side was 0.48.Among the 4 cases with pyramidal tract involvement,there was motor dysfunction of the lateral limbs.Conclusion Through the analysis of this group of cases,it is suggested that the damage of the frontal nerve tract can produce partial loss of cognitive function.Consistent with the

关 键 词：磁共振弥散张量成像 脑损伤 神经束 部分各向异性FA值 

分 类 号：R74[医药卫生—神经病学与精神病学]