DTI及DTT技术在ACT患者预后评价中的应用价值

Application Value of DTI and DTT in the Evaluation of Acute Ischemic Cerebral Infarction

目的探讨MR扩散张量成像(DTI)及白质纤维束成像(DTT)技术在急性缺血性脑梗塞患者预后判断评价中的应用价值,为临床提供参考。方法对所有34例患者在急性期(发病时间<72h)行常规头颅MRI检查、DTI检查,根据白质纤维束(corticospinal tract,CST)与梗死灶的关系分为相邻(10例)、部分穿过(13例)及完全穿过(11例)共三组,将其功能结局分别预测为痊愈、部分恢复及瘫痪并作为预测理论值(100%);最后通过随访并对所有的患者进行MMT肌力测试,将结果作为预后评价的实际值与上述理论值作一对比并进行评价,判断二者符合率。结果相邻组患者的实际符合率90.0%(9/10),部分穿过组患者的实际符合率为84.6%(11/13),完全穿过组患者的实际符合率为90.9%(10/11)。三组的实际值均接近于理论值,无统计学意义(P>0.05)。结论采用梗死灶与CST关系进行预后判断的符合率较高,能够较好的进行急性脑梗塞患者的预后判断。

Objective To explore the value of MR diffusion tensor imaging （DTI） and diffusion tensor tractography （DTT） in the evaluation of prognosis of acute ischemic cerebral infarction. Methods All 34 patients in acute phase （onset〈72h） were performed with 1.5T conventional MRI, DTI and DTT. Three patterns were identified according to the relation ofcorticospinal tract （CST） and infarction： close（11 patients）, partly involved （13 patients） and completely involved（11 patients）. The prognosis were fully recovery, partial recovery and paralysis, and they are regarded as theoretical predicted value（100%）. After therapy, the patients were evaluated by MMT test, and the results were compared with above theoretical values. The coincident rate of them were compared. Results The actual coincidence of the close group is 90.0% （9/10, P 〉 0.05）, partly involved group is 84.6%（11/13, P 〉 0.05） and completely involved group is 90.9%（10/11, P 〉 0.05）. The actual coincidence of the three groups were close to the theoretical value, and no statistical significance was observed （P 〉 0.05）. Conclusion The prognosis has high coincidence according to the relationship of CST and infarction. It can be used for the prognosis in patients with acute cerebral infarction.