急性期脑出血锥体束损伤的磁共振扩散张量纤维束成像评价

Evaluation of Pyramidal Tract Injury in Acute Intracerebral Hemorrhage with MR Diffusion Tensor Tractography

目的评价扩散张量纤维束成像(Diffusion tensor tractography,DTT)技术观察急性期脑出血锥体束损伤与其功能恢复的关系。方法对30例发病2周以内的基底节或丘脑出血患者进行磁共振DTT评价锥体束的完整性,发病后6个月应用Barthel指数(Barthel Index,BI)评价其功能恢复。比较各组BI评分以及分析锥体束完整性与BI评分的相关性。结果除7例资料不完整被剔除外,23例患者资料纳入统计。锥体束完整性不同的各组间BI评分有统计学差异(F=9.693,P<0.01)。急性期磁共振扩散张量成像(Diffusion tensor imaging,DTI)所显示的锥体束完整性与发病6月后BI评分有良好的相关性,具有统计学差异(r=0.733,P<0.01)。结论脑出血急性期应用DTT评价锥体束的完整对患者运动功能的恢复有预测价值。

Objective To evaluate the relationship between pyramidal tract injury in acute intracerebral hemorrhage assessed by MR diffusion tensor tractography(DTT) techniques and motor rehabilitation. Methods Diffusion tensor imaging was performed on 30 patients with basal ganglia or thalamus hemorrhage within 2 weeks after upsets, and the integrity of the pyramidal tracts was assessed by DTT. Motor function rehabilitation was assessed with Barthel Index(BI) after 6 months from upsets. BI scores of the different groups were compared and the correlation was analyzed between the integrity of the pyramidal tracts and the BI scores. Results 7 cases were eliminated because of unsatisfi ed data and 23 cases were enrolled. BI scores had significant difference among the groups divided by DTT findings of the pyramidal tracts integrity(F=9.693, P<0.01). There was signifi cant correlation between the integrity of the pyramidal tracts in acute stage and the BI scores after 6 months(r=0.733, P<0.01). Conclusion The DTT fi ndings for pyramidal tract in acute intracerebral hemorrhage may be used to predict the motor outcome.