DTI技术在评估微创引流治疗HICH患者预后及认知中的应用  

Application of Diffusion Tensor Imaging in the Evaluation of Prognosis and Cognition of Patients with Hypertensive Intracerebral Hemorrhage with Minimally Invasive Drainage

作　　者：刘兴宇[1] 田宝刚 崔建忠[1] 张晓飞 王凯杰[1] 洪军[1] 王余 王海波[1] 魏建强[1] 魏玲 LIU Xingyu;TIAN Baogang;CUI Jianzhong(Department of Neurosurgery,Tangshan Gongren Hospital,Tangshan,Hebei Province 063000,China)

机构地区：[1]唐山市工人医院神经外科,063000 [2]唐山市工人医院磁共振室,063000

出　　处：《临床放射学杂志》2022年第6期1155-1160,共6页Journal of Clinical Radiology

基　　金：河北省科技支撑项目(编号:162777156)。

摘　　要：目的探究高血压脑出血(HICH)患者中扩散张量成像(DTI)技术在预后及认知损伤评估中的应用前景。方法搜集50例出血量15~30 ml的HICH患者,均采取微创引流术治疗,DTI测量入院时、术后第21天时患者患侧皮质脊髓束(CST)分级及内囊各向异性分数(FA),按CST分级,分为微创1组和微创2组。采用美国国立卫生研究院卒中量表(NIHSS)于入院时及术后第21天时行瘫痪分级(PG),于术后6个月应用重复性成套神经心理状态测验量表(RBANS)评估患者认知功能。结果微创1组患者术后21天时PG值与微创2组相比,有统计学差异(t=8.634,P<0.001)。患者术后21天患侧FA值与入院时血肿体积及术后21天时PG值均呈负相关(P均<0.05)。多元线性回归分析发现,HICH患者术后21天患侧FA值与即刻记忆(t=-2.995)、术后21天PG值(t=-2.965)、延迟记忆(t=2.330)相关(P均<0.05)。结论HICH患者微创引流术后21天患侧FA值越低,CST等级越高,预后越差,认知功能越差;DTI技术可用于评估微创引流术治疗的HICH患者预后及认知功能。Objective To explore the application of diffusion tensor imaging(DTI)in the evaluation of prognosis and cognition of patients with hypertensive intracerebral hemorrhage(HICH)treated with minimally invasive drainage.Methods 50 HICH patients with hematoma volume between 15-30 ml with minimally invasive drainage were included.All patients were detected at the time admitted to hospital and postoperative for 21 days by using DTI to obtain both fractional anisotropy(FA)and corticospinal tract(CST)integrity grading.Then,patients were divided into two groups:Minimally Invasive Group 1 and Minimally Invasive Group 2 according to CST grading.The National Institutes of Health Stroke Scale(NIHSS)was used to assess the prognosis at the time admitted to hospital and postoperative for 21 days using paresis grading(PG)value.Using the RBANS scale to assess the cognitive function of patients at 6 months after surgery.Results At 21 days after operation,the PG value of patients in minimally invasive group 1 was lower than that of patients in minimally invasive group 2(t=8.634,P<0.001).The FA value of the affected brain of HICH patients at 21 days after operation was negatively correlated with the PG value at 21 days after operation,as well as the volume of hematoma at admission(all P<0.05).In multiple linear regression analysis,the FA value of the affected side 21 days after the operation was related with the PG value 21 days after the operation(t=-2.965),immediate memory(t=-2.995),delay Memory(t=2.330)(all P<0.05).Conclusion At 21 days after minimally invasive drainage in HICH patients,the lower the FA value of the affected brain of HICH patients was,as well as the higher the CST grade was,the worse the prognosis and cognitive function were.DTI technology can be used to evaluate the prognosis and cognitive function of HICH patients treated with minimally invasive drainage.

关 键 词：高血压脑出血 基底节 微创引流术 扩散张量成像 预后 认知 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.34[医药卫生—诊断学]