DTI在皮层下脑卒中患者皮质脊髓束损伤中的应用

A DTI study on injury of corticospinal tract after subcortical stroke

目的扩散张量成像（DTI）扫描下探讨皮质脊髓束损伤与卒中后上肢功能障碍之间的关系以及其损伤的机制。方法在康复治疗前后对8例皮层下脑卒中后3～9月的上肢偏瘫患者进行一次DTI检查，对DTI数据进行软件后处理。结果在8例脑卒中患者的扩散张量纤维束成像（DTT）上可见皮质脊髓束部分中断。在病灶及大脑脚水平上，分别测量双侧皮质脊髓束的部分各向异性（FA）值及表观扩散系数（ADC）值，患侧与健侧的FA值及ADC值均有显著性差异（P〈0．05）。结论所有皮层下脑卒中后3—9月的患者皮质脊髓束在病灶水平部分中断，在远处发生变性等继发改变。DTI在此领域有广阔的应用前景。

Objective To examine upper-limb hemiparetic patients with subcortical stroke with DTI . Methods BOLD-fMRI with a 1.5T scanner performed DTI, corresponding software was used to process the data of DTT. Results Interruption or impairment of cortieospinal tract was seen in DTT picture of 8 patients. The results from FA maps and ADC maps at the level of lesion and cerebral peduncle showed that the value of FA in lesion was significantly lower than that in the region of opposite side （ P 〈 0. 05 ） and the value of ADC in lesion was significantly higher than that in the region of opposite side （P 〈 0. 05 ）. Conclusion In all patients with a subcortieal stroke 3 to 9 months, the corticospinal tract of patients with subcortical stroke defect or interrupt at the level of lesion, and exist secondary damage such as degeneration in remote areas. DTI will play an important role in this field.