磁共振弥散张量成像在急性腔隙性脑梗死预后评估中的价值

Clinical value of magnetic resonance diffusion tensor imaging in the prognosis evaluation of acute lacunar infarction

目的探讨磁共振弥散张量成像(DTI)在急性腔隙性脑梗死患者预后评估中的临床价值及相关性。方法急性腔隙性脑梗死患者40例,在MRI常规检查的同时加做DTI检查,得到各向异性分数伪彩图并测量分析梗死灶各向异性分数值,重建双侧皮质脊髓束,以梗死灶在双侧皮质脊髓束的空间位置分为纤维束外、纤维束旁、纤维束内3组;每次磁共振检查之前进行Fugl-Meyer运动功能评分评定,最后分析梗死灶位置与运动功能评分之间的关系。结果康复治疗前后病灶与皮质脊髓束越空间关系越密切的,运动功能评分增加的百分数越低,呈负相关(P<0.01)。结论通过DTI在急性腔隙性脑梗死灶与双侧皮质脊髓束的空间位置关系的水分子扩散各向异性分值及扩散张量纤维束成像分级,可以较准确、直观地显示皮质脊髓束的损伤程度,为脑梗死患者临床治疗及预后提供明确的依据。

Objective To explore spatial position of the acute lacunar infarction lesions in corticospinal tract, the relationship between limb motor function and acute lacunar infarction, and assess the clinical value of magnetic resonance diffusion tensor imaging （DTI） in prognosis of patients with acute lacunar infarction. Methods Forty cases of lacunar infarction in patients with acute were performed with the conventional MRI and DTI examination at the same time. Fractional anisotropy and the measurement of pseudocolor value FA infarction, reconstruction bilateral cortical spinal tract were analyzed.In the spatial position of CST, the infarct were divided into 3 groups： fiber bundle, fiber bundle and fiber bundle.Fugl-Meyer motor function score was assessed before each MR examination. Relationship between the location of the infarct and the Fugl-Meyer motor function score was analyzed. Results There was a negative correlation between the increase of Fugl-Meyer exercise score and the lesion before and after the rehabilitation treatment （P〈0.01）. Conclusion DTI diffusion of water molecules through the spatial relationship of acute lacunar infarction foei and the CST anisotropy and DTT classification can accurately display the degree of injury of the corticospinal tract, cerebral infarction patients. It would provide a clear basis for the clinical treatment and prognosis of patients with cerebral infarction.