DTI联合DTT检测的患侧FA值下降百分比对老年脑梗死患者病程的评估价值及白质纤维束分级与NIHSS评分相关性  

The Value of DTI Combined with DTT Detection of the Percentage Decrease of FA Value on the Affected Side in Evaluating the Course of Disease in Elderly Patients with Cerebral Infarction and the Correlation between White Matter Fiber Tract Classification and NIHSS Score

作　　者：王凯 张贵兴 黄叶明 冯冲冲 WANG Kai;ZHANG Guixing;HUANG Yeming;FENG Chongchong(Xiamen Fifth Hospital,Fujian Province,Xiamen 361101,China;不详)

机构地区：[1]福建省厦门市第五医院,福建厦门361101

出　　处：《中国医学创新》2023年第14期147-151,共5页Medical Innovation of China

摘　　要：目的:探究磁共振弥散成像(DTI)联合弥散张量纤维束成像技术(DTT)检测的患侧FA值下降百分比对老年脑梗死患者病程的评估价值及白质纤维束分级与NIHSS评分相关性。方法:回顾性分析2020年1月-2022年1月厦门市第五医院收治的80例老年脑梗死患者的临床资料。患者均接受常规磁共振成像(MRI)平扫、弥散加权成像(DWI)、DTI、DTT检查。根据病程将患者分为急性期组(≤3 d)、亚急性期组(4 d~3周)、慢性期组(>3周),以美国国立卫生研究院卒中量表(NIHSS)评分评估患者的预后,分析DTI联合DTT检测结果的患侧FA值下降百分比和白质纤维束分级对老年脑梗死患者病程和预后的评估价值。结果:80例患者中,DTI联合DTT测出86个病灶,其中脑叶白质30个,基底节区34个,丘脑6个,放射冠区10个,半卵圆中心6个;慢性期组的患侧部分各向异性(FA)值、患侧FA值下降百分比均高于急性期组、亚急性期组患者,亚急性期的患侧FA值下降百分比高于急性期组患者,差异均有统计学意义(P<0.05);绘制受试者工作特征(ROC)曲线显示,患侧FA值下降百分比评估老年脑梗死患者病程的曲线下面积(AUC)为0.953;白质纤维束分级3级和2级患者入院时和出院时NIHSS评分均高于1级患者,且3级患者高于2级患者,差异均有统计学意义(P<0.05);Spearman相关性分析结果显示,老年脑梗死患者的白质纤维束分级与入院时NIHSS评分、出院时NIHSS评分呈正相关(rs>0,P<0.05)。结论:DTI联合DTT可以有效预测老年脑梗死患者的病程及预后,诊断价值较高。Objective:To explore the value of the percentage decrease of the FA value on the affected side detected by magnetic resonance diffusion tensor imaging(DTI)combined with diffusion tensor tractography(DTT)in evaluating the course of disease in elderly patients with cerebral infarction,and the correlation between white matter fiber tract classification and NIHSS scores.Method:The clinical data of 80 elderly patients with cerebral infarction admitted to Xiamen Fifth Hospital from January 2020 to January 2022 were retrospectively analyzed.All patients underwent routine magnetic resonance imaging(MRI)plain scan,diffusion-weighted imaging(DWI),DTI,and DTT examinations.The patients were divided into acute stage group(≤3 d),subacute stage group(4 d-3 weeks),and chronic stage group(>3 weeks)according to the course of disease.The national institutes of health stroke scale(NIHSS)score was used to evaluate the prognosis of the patients.The value of DTI combined with DTT test results of FA decline on the affected side and the classification of white matter fiber tracts in the assessment of the disease course and prognosis of elderly patients with cerebral infarction based on the percentage were analyzed.Result:Among the 80 patients,86 lesions were detected by DTI combined with DTT,including 30 lesions in the white matter of the lobe,34 in the basal ganglia,6 in the thalamus,10 in the corona radiata,and 6 in the center of the semiovale.The fractional anisotropy(FA)value of the the affected side and the percentage of decrease in the FA value of the the affected side were higher than those of the patients in the acute phase group and subacute phase group,and the percentage of decrease in the FA value of the the affected side in the subacute phase was higher than that of the patients in the acute phase group,the differences were statistically significant(P<0.05).The receiver operating characteristic(ROC)curve plotting showed that the area under the curve(AUC)for evaluating the disease course of elderly patients with cerebral inf

关 键 词：脑梗死 磁共振弥散成像 弥散张量纤维束成像技术 部分各向异性 白质纤维束 

分 类 号：R743.33[医药卫生—神经病学与精神病学]