表观弥散系数和各向异性值对脑出血术后疗效的预测价值

Predictive value of apparent dispersion coefficient and fractional anisotropy in the treatment of postoperative hemorrhage

目的研究表观弥散系数（ADC）和各向异性值（FA）对脑出血患者术后疗效的预测价值。方法回顾性分析76例在延安市人民医院神经外科就诊并进行手术治疗的脑出血患者，按照预后是否良好分为预后良好组和预后不良组，采用磁共振弥散张量成像（DTI）检测脑出血术后2周内所有受试对象的ADC和FA值，分析ADC、FA对脑出血术后的预测价值。结果脑出血手术清除率达到82．9％。Logistic回归分析显示，ADC、FA、糖尿病、高血压病为脑出血患者术后预后的影响因素。FA值诊断手术预后的曲线下面积为0．804（95％CI：0．710～0．899），ADC为0．771（95％CI：0．669-0．872），而ADC＋FA诊断脑出血术后的曲线下面积为0．872（95％CI：0．791～0．953）。结论ADC和FA对脑出血术后疗效的预测具有一定的临床价值。

Objective To investigate the predictive value of apparent dispersion coefficient（ADC） and fractional anisotropy（FA） in the treatment of postoperative hemorrhage. Methods Totals of 76 patients who underwent neurosurgical treatment of cerebral hemorrhage in Department of Neurosurgery, Yan＇ an People＇ s Hospital were analyzed retrospectively. Patients were divided into good prognosis group and poor prognosis group according to their prognosis. The ADC and FA values of patients with intracerebral hemorrhage were measured by magnetic resonance diffusion tensor imaging. The predictive value of ADC and FA in the treatment of cerebral hemorrhage was analyzed. Results The rate of cerebral hemorrhage eliminating was 82.9%. Logistic regression analysis showed that ADC, FA, diabetes mellitus and hypertension were prognostic factors of postoperative cerebral hemorrhage. The area under the curve of FA diagnosed cerebral hemorrhage was 0.804 （95%CI： 0.710-0.899）, ADC was 0.771（95%CI： 0.669-0.872）, while ADC＋FA was 0.872（95%CI： 0.791-0.953）. Conclusions ADC and FA have certain clinical values in predicting the curative effect of cerebral hemorrhage.