摘要
目的研究梗死灶弥散张量成像(DTI)参数变化与梗死灶体积和临床症状的相关性,探讨DTI在缺血性脑卒中的临床应用价值。方法对10例单侧急性脑梗死患者于发病3d内行3.0T常规磁共振(MRI)和DTI检查,测量梗死灶和对侧相应正常脑组织的部分各向异性值(FA)、梗死灶体积,并运用弥散张量纤维束成像(DTT)显示通过病灶的纤维束特征。结果患者梗死侧FA值较对侧相应正常脑组织降低(P=0.002)。梗死侧FA值和FA值下降百分比随发病时间的延长呈下降趋势(r值分别为-0.273及-0.818,P值分别为0.446和0.004)。梗死侧脑组织FA值降低百分比和美国国立卫生院脑卒中量表(NIHSS)无相关性(r=-0.554,P=0.097)。梗死灶体积和NIHSS评分存在正相关(r=0.843,P=0.002)。纤维束成像可见:梗死灶处纤维束和对侧正常脑组织相比,通过病灶的纤维束直径变细,数量减少,部分纤维束中断。结论脑梗死急性期和亚急性早期,FA值降低百分比随病程的延长而增加,可用于反映脑梗死的病程,DTT可直观显示纤维束走行及与病灶之间的关系,在判断患者预后及指导患者康复治疗等方面具有重要作用。
Objective To assess the correlations between the change of parameters of diffusion tensor imaging and the clinical symptoms, volume of infarcts, and alteration of fiber tract in patients with isehemic stroke. Methods Ten patients diagnosed as acute infarcts underwent 3. 0T conventional MRI and diffusion tensor imaging examinations 3 days after the onset of illness. The FA values of the lesions and the eontralateral corresponding brain tissues were obtained and the volumes of infarcts were calculated. Visualization of the fiber tract was achieved by postprocessing the acquired diffusion tensor imaging data. Results All patients had a decrease in FA values of the lesions compared with the contralateral corresponding brain tissues （P=0. 002）. The percentage of decrease in FA values was correlated with the duration of the infarct attack （correlation coefficient=- 0. 818, P= 0. 004）. The percentage of decrease in FA values of the infarct lesions was not correlated with the NIHSS scores （correlation coefficient=-0. 554, P=0. 097）. There was a significant positive correlation between the volume of infarcts and the NIHSS scores （correlation coefficient= 0. 843, P=0. 002）. Disruption and attenuation of the fiber tract was observed in the infarct lesions. Conclusion The FA values of the infarct lesions decrease with the course of the disease in the acute and early subaeute stage of ischemic stroke. The larger the infarct volume is, the more serious the clinical manifestation is. DTI can show the relationship between the direction and morphology of the fiber tract and the infarct lesions, which will play an important role for judging the prognosis of the patients and informing rehabilitation plans.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2009年第3期551-554,F0003,共5页
Journal of Sichuan University(Medical Sciences)
基金
国家重点基础研究发展计划"973"(2007CB512305)
国家高技术研究发展计划"863"(2007AA02Z430)资助
作者简介
Corresponding author, E-mail： heli2003new@126.com
