MR扩散张量在临床脑梗死运动功能康复评估中的应用

Diffusion tensor imaging in the rehabilitation of cerebral infarction patients

目的使用扩散张量成像（DTI）研究脑梗死不同时期的扩散张量的变化规律，并试图通过扩散张量纤维束成像（DTT）探讨皮质脊髓束（CST）损伤与运动功能恢复的关系。方法26例脑梗死患者行常规MRI及DTI检查，测量各期病灶及对侧相应正常区域脑组织的平均扩散系数（DCavg）、部分各向异性系数（FA）、容积比（1-VR）及相对各向异性系数（RA）值，同时进行统计学分析；并行白质纤维束三维重建。结果各期病灶与对侧各参数值间的差异均有统计学意义（P〈0．01）；各期病灶各参数值间的差异亦有统计学意义（P〈0．01）。DTT可显示脑白质纤维束的破坏、推移或扭曲等征象，CST的损伤情况与运动功能的恢复有良好的相关。结论梗死灶DTI各参数值的变化具有规律性，DTT对观察CST的损害程度、预测恢复程度、指导临床康复治疗具有重要的参考价值。

Objective To explore the manifestation of the different stages of cerebral infarction （CI） in terms of diffusion tensor imaging （DTI） , and to evaluate the relationship between cortical spinal tracts （CST） and motor recovery （MR） via diffusion tensor tractography （DTT）. Methods Twenty-six CI patients at different stages of recovery were imaged with conventional MRI and DTI. DCavg, fractional anisotropy （FA） , 1 and the VR and relative ani- sotropy （RA） of the abnormal and contra-lateral sides were measured. Results The DCavg, FA, 1-VR, and RA values differed significantly between the abnormal and eontra-lateral sides at all stages of recovery. The signs of tractography, including fracture, movement, and twist could be shown by DTT. And the configuration of the CST was closely correlated with MR. Conclusion DTT could greatly contribute to estimating the degree of damage to CST, and to monitoring MR and the clinical rehabilitation process by detecting changes in DCavg, FA, I-VR, and RA.