磁共振扩散张量成像在颅脑疾病的初步应用

Clinical application of diffusion tensor imaging in diagnosis of craniocerebral diseases

目的评价磁共振扩散张量成像(diffusion tensor imaging,DTI)在颅脑疾病中的临床应用价值。方法采用Siemens1.5TMRI成像系统对6名健康志愿者以及6名神经系统疾病患者脑部进行常规T1WI、T2WIMRI检查及扩散张量成像,采用DtiStudio软件对DTI图像进行分析处理,显示脑白质纤维,并测量肿瘤周围白质及健侧对应区域的部分各向异性(fractionalanisotropy,FA)值。结果扩散张量FA图可清楚显示脑白质内大部分主要的白质纤维束。3例缺血性脑卒中患者可观察到锥体束不同程度的中断。3例脑肿瘤患者可以观察到锥体束、胼胝体或内囊、外囊受压、移位及浸润破坏,周围白质纤维被浸润破坏后FA值较健侧明显降低。结论扩散张量成像可在活体内清楚显示脑白质纤维束的受损和移位,有利于临床制订手术方案和对预后功能恢复进行评估。

Objective To value the clinical application of diffusion tensor imaging （DTI） in cerebral diseases. Methods Six volunteers and 6 patients （including 3 patients with ischemic stroke and 3 patients with glioma） were examined by DTI and T1 -weighted, T2-weighted MR scan. All data were processed with DtiStudio software to show the white matter fiber tracts. The fractional anisotropy （FA） of the diffusion tensor were measured between the affected and the unaffected side. Results The white matter fiber tract could be observed clearly on the FA map. The pyramidal tract with different degree disruption could be showed in 3 patients with ischemic stroke. Compression, displacement, infiltration or destruction of pyramidal tract, corpus callosum or internal capsule and external capsule could be seen in 3 patients with glioma, and FA was significantly reduced on the affected side as compared to the unaffected side. Conclusion Diffusion tensor imaging is useful in ob- serving the damage and displacement of the white matter fiber tracts in vivo, beneficial to the surgical plan for patients and prognosing recovery of function.