基于磁共振扩散张量成像的急性脑梗死白质纤维束损伤研究  

The Study on Injury of White Matter Fiber Tracts in Acute Cerebral Infarction Based on Magnetic Resonance Diffusion Tensor Imaging

作　　者：黄锋 陈飞 胡建斌[1] 李新[1] 穆天池 姚立正[1] Huang Feng;Chen Fei;Hu Jianbin;Li Xin;Mu Tianchi;Yao Lizheng(Department of Radiology,Yancheng Third Peoples Hospital(The Yancheng School of Clinical Medicine of Nanjing Medical University),Yancheng,Jiangsu 224001)

机构地区：[1]盐城市第三人民医院(南京医科大学盐城临床医学院)影像科,江苏盐城224001

出　　处：《现代医用影像学》2021年第5期805-807,834,共4页Modern Medical Imageology

基　　金：江苏省卫生健康委2019年度医学科研项目,项目编号:H2019088;江苏省第十六批“六大人才高峰”高层次人才项目,项目编号:WSN-313;盐城市医学科技发展计划项目,项目编号:YK2017116,YK2019106。

摘　　要：目的:探讨磁共振(MR)扩散张量成像(DTI)评估急性脑梗死白质纤维束损伤的价值以及与神经功能的相关性。方法:回顾性分析2014年7月至2016年1月在我院就诊的39例幕上单侧急性脑梗死患者的临床和MR资料。在DTI序列各项异性指数(FA)和平均弥散系数(MD)参数图上选取梗死病灶及对侧为感兴趣区(ROI),并以ROI为种子点拟合扩散张量纤维束成像(DTT)图。比较梗死病灶与对侧ROI的FA和MD值改变。计算梗死侧/对侧的参数相对值(rFA和rMD),分析两者与患者入院神经功能的相关性。入院神经功能以美国国立卫生研究院卒中量表(NIHSS)评定。结果:DTT显示梗死病灶区白质纤维束损伤。梗死病灶FA和MD值均明显低于对侧(均P<0.05)。rMD值与入院NIHSS评分呈明显负相关(r=-0.540,P=0.001)。结论:基于DTI可有效评估急性脑梗死白质纤维束损伤,并且rMD值与患者入院神经功能具有明显负相关,为急性脑梗死患者的临床诊治提供参考。Objective:To investigate the value of magnetic resonance(MR)diffusion tensor imaging(DTI)in assessing white matter fiber tracts injury in acute cerebral infarction and its correlation with neurological function.Methods:The clinical and MR data of 39 patients with unilateral supratentorial acute cerebral infarction who visited our hospital from July 2014 to January 2016 were retrospectively analyzed.Infarcts and contralateral areas were selected as regions of interest(ROI)from the fractional anisotropy(FA)and mean diffusivity(MD)parameter maps of DTI sequence,and diffusion tensor tractograph(DTT)were fitted with ROI as seed points.The FA and MD values of infarct lesions and contralateral ROI were compared.The relative parameters values of the infarct side/contralateral(rFA and rMD)were calculated,and the correlation between them and the patient’s admission neurological function were analyzed.Neurological function on admission was assessed by the National Institutes of Health Stroke Scale(NIHSS).Results:DTT show the injury of white matter fiber tracts in the infarcted area.The FA and MD values of the infarct lesions were significantly lower than those of the contralateral areas(all P<0.05).There was significant negatively correlated between rMD and admission NIHSS scores(r=-0.540,P=0.001).Conclusion:DTI can effectively evaluate the injury of white matter fiber tracts of acute cerebral infarction,and the rMD value is significantly negatively correlated with the admission neurological function of patients,it provide a reference for the clinical diagnosis and treatment of acute cerebral infarction patients.

关 键 词：磁共振成像 扩散张量成像 急性脑梗死 白质纤维束 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.33[医药卫生—诊断学]