扩散张量成像在脑梗死病程中的研究及临床意义

The Clinical Signification of Diffusion Tensor Imaging in the Progression of Stroke

目的应用MR扩散张量成像(DTI)对急性期脑梗死患者病灶表观扩散系数(ADC)与各向异性分数(FA)值及大脑脚ADC值8周变化进行分析,探讨其对患者病情变化反映的价值。资料与方法筛选急性脑梗死患者20例,于急性期行常规T2WI、液体衰减反转恢复(FLAIR)及DTI扫描并行NIHSS和BI评分连续复查8周,每周一次,分析梗死病灶ADC与FA值及大脑脚ADC值变化。结果梗死灶ADC值于发病开始即呈逐渐上升趋势,FA值总体呈下降趋势,病灶双侧大脑脚ADC值变化趋势同梗死灶。患者恢复情况越好,ADC值与FA值的变化趋势越缓和,反之则变化趋势越陡峭。结论脑梗死偏瘫患者病灶处及远隔部位大脑脚ADC及FA值变化情况能提示患者预后,并提示存在华勒变性及脑功能重组。

Objective To investigate the variation of ADC and FA in patients with acute cerebral infarction during 8 weeks.Materials and Methods Serial of DTI,FLAIR and T2WI scan were performed in 20 patients with acute cerebral infarction.The values of ADC and FA at infarction area and cerebral peduncle were calculated and compared.Results At infarction area,the ADC were increased and FA were decreased during the progression.The same varation of ADC were observed at bilateral cerebral peduncle.The better recovery the less variation of ADC and FA.Conclusion DTI is sensitive in diagnosing acute cerebral infarction.The variation of ADC and FA can reflect prognosis,reveal the wallerian degeneration and brain functional reconstruction.