弥散张量成像在高血压性脑出血中的临床应用初探

Preliminary application study of magnetic resonance diffusion tensor imaging in hypertensive intracerebral hemorrhage in basal ganglion region

目的应用磁共振弥散张量成像技术观察基底节区高血压性脑出血皮质脊髓束的受损情况,为临床干预治疗提供可靠依据。方法对9例基底节区HICH患者进行磁共振弥散张量成像检查,分别测量患侧皮质脊髓束受压区及健侧皮质脊髓束相应区域的FA值,并重建一名患者的FA图、方向编码彩色图、双侧皮质脊髓束3D纤维束图。结果患侧皮质脊髓束的FA值均较对侧降低,两侧相比差异有显著性意义(t=4.9041,P<0.05);患侧皮质脊髓束区FA值下降百分比和NIHSS评分有明显相关性(r=0.8336,P<0.05);皮质脊髓束3D纤维束图可显示病变侧皮质脊髓束受损情况。结论通过弥散张量成像可以了解基底节区HICH患者的皮质脊髓束的损伤情况,这有助于临床医生全面掌握病情,开展干预性治疗。

Objective To study the impairment degree of cortical spinal tract（CST） of 9 cases with hypertensive intracerebral hemorrhage in basal ganglion region by using MR diffusion tensor imaging （DTI） ,and to gain theoretical data for establishment of therapeutic plan. Methods 9 patients with hypertensive intracerebral hemorrhage in basal ganglion region were performed DTI using GE sina exite imaging system. The FA value were measured in the region of compressed CST and corresponding contralateral normal regions, and one patient＇s fractional anisotropy maps, directionally encoded color maps and 3D tractography of bilateral CST were created. Results The FA vaiue in the region of compressed CST was significantly lower than that in normal hemisphere （paired test, t = 4. 9041, P 〈 0.05 ）. The decreasing percentage of FA value in the region of compressed CST had significantly positive correlation with NIHSS scores （ r = 0. 8336, P 〈 0.05 ） ; diffusion tensor tracking could show that the CST were compression, displacement and break. Conclusion For patients with hypertensive intracerebral hemorrhage in basal ganglion region, We can evaluate their impairment degree of CST by using diffusion tensor imaging, and has important value for clinician to establishment of therapeutic plan.