弥散张量成像在轻度颅脑损伤诊断与治疗的应用价值

Applied value of diffusion tensor imaging in the diagnosis and treatment of mild traumatic brain injury

目的研究扩散张量成像(diffusion tensor imaging,DTI)各向异性分数(fractional anisotropy,FA)和平均扩散系数(mean diffusivity,MD)在轻度颅脑损伤(mild traumatic brain injury,m TBI)诊治的应用价值。方法收集m TBI病例(m TBI组)24例与正常体检者(对照组)9例,行常规MRI检查与DTI序列扫描。应用软件ExploreDTI进行三维重建,勾画感兴趣(region of interest,ROI)脑区,分析各脑区FA值和MD值的组间差异性。结果在m TBI组与对照组24个脑区的FA值和11个脑区的MD值,差异具有统计学意义(均P<0.05)。两组间FA值与MD值均异常脑区10个,其中9个脑区的FA值与MD值存在负相关关系(均r<0、P<0.05)。结论DTI序列检查发现m TBI病人多个脑区存在白质纤维束损伤,为m TBI治疗提供依据。受损脑区FA值降低,MD值升高,FA值和MD值在m TBI诊断中具有互补作用。

Objective To study the value of fractional anisotropy(FA)and the mean diffusivity(MD)of diffusion tensor imaging(DTI)in the diagnosis and treatment of mild traumatic brain injury(m TBI).Methods Twenty-four patients with m TBI(m TBI group)and 9 patients with normal physical examination(control group)were enrolled.Routine MRI and DTI sequence scanning were performed.The application software ExploreDTI was used for 3 D reconstruction,and regions of interest(ROI)were delineated.The differences between the FA value and MD value in each brain region were collected and analyzed.Results In the m TBI group and the control group,the FA values of 24 brain regions and the MD values of 11 brain regions were significantly different(both P<0.05).There were 10 abnormal brain regions in both FA and MD values of the two groups,and there was a negative correlation between FA values and MD values in 9 brain regions(both r<0,P<0.05).Conclusions DTI sequence examination reveal white matter fiber bundles damage in multiple brain regions of m TBI patients,providing a basis for m TBI treatment.The FA value in the damaged brain area is decreased,the MD value is increased,and so FA value and MD value have complementary roles in m TBI diagnosis.