磁共振弥散张量成像对脑出血致皮质脊髓束损害的诊断价值

Diagnostic value of magnetic resonance diffusion tensor imaging on cortical spinal tract impairment induced by intracerebral hemorrhage

目的研究磁共振弥散张量成像(DTI)对脑出血致皮质脊髓束(CST)损害的诊断价值。方法对20例基底节区脑出血患者(急性期14例,亚急性期6例,均有偏瘫)进行DTI检查,分别测量患侧CST损害区及健侧相应区域的各向异性分数(FA)值、表观弥散系数(ADC)值。结果 DTI显示20例脑出血患者患侧CST受压、移位、变薄或显示不清,患侧CST受损区FA值(0.43±0.16)均较健侧(0.70±0.06)明显降低(t=9.11,P<0.01);14例急性期患者患侧受损CST区ADC值(0.60±0.11)较健侧(0.76±0.10)明显降低(t=7.03,P<0.01),6例亚急性期患者两侧CST区ADC值的差异无统计学意义。结论 DTI可以清楚地显示脑出血患者CST的损害状况,这对判断脑出血患者的病情和预后有参考价值。

Objective To study the diagnostic value of magnetic resonance diffusion tensor imaging（DTI） on cortical spinal tract（CST） impairment induced by intracerebral hemorrhage.Methods 20 patients with intracerebral hemorrhage in basal ganglion region （14 cases of acute period,6 cases of subacute period,all had hemiplegia） were examined by DTI.The fractional anisotropy（FA） value and apparent diffusion coefficient （ADC） value were measured in the region of compressed CST and corresponding contralateral normal regions.Results DTI showed that ipsilateral CST were compression,displacement,thinning out or showed unclear in all the patients.The FA value in the region of compressed CST（0.43±0.16） of all the patients was significantly lower than that in the normal hemisphere（0.70±0.06）（t=9.11,P〈0.01）.The ADC value in the region of compressed CST（0.60±0.11） in 14 cases of acute period was significantly lower than that in the normal hemisphere（0.76±0.10）（t=7.03,P〈0.01）.There was no significant difference of ADC value between the region of compressed CST and control sides in 6 cases of subacute period.Conclusions For patients with intracerebral hemorrhage at basal ganglion region,impairment degree of CST can be clearly displaid by DTI.It has important value to determine the condition of patients with cerebral hemorrhage and prognostic assessment.