脑卒中后皮质脊髓束损伤与运动功能的相关性及磁共振弥散张量成像的价值分析

The value of diffusion tensor imaging in corticospinal tract injury and motor function after stroke

目的分析脑卒中后皮质脊髓束(CST)损伤与运动功能的相关性及磁共振弥散张量成像(DTI)的价值。方法本次所选研究对象均为本院收治的脑卒中患者,共46例,选取时间段为2017年8月至2018年9月;将研究对象划分为两组,脑出血组和脑梗死组,并给予两组患者DTI扫描,测量病变同侧的CST以及病变对侧对应脑组织部分的异性值(FA),同时,采用Fugl-Meye运动功能评分法(FMA)评估患者偏瘫肢体的运动功能。结果两组患者病灶同侧的FA值均低于对侧对称部位脑组织的FA值(P<0.05),脑梗死组病灶同侧病灶大脑脚、放射冠区、内囊后肢以及初级皮质运动区域均与FA值、rFA值、FAasy值与FMA评分密切相关(P<0.05),脑出血组病灶同侧大脑脚、放射冠区、内囊后肢层的FA值、rFA值、FAasy值与FMA评分密切相关(P<0.05)。结论磁共振弥散张量成像能够有效评估脑卒中后皮质脊髓束损伤与运动功能的相关性,具有临床积极意义。

Objective To analyze the value of diffusion tensor imaging (DTI)in the correlation between cortical spinal cord tract (CST) injury and motor function after stroke. Methods The selected subjects of this study were all stroke patients admitted to our hospital, a total of 46 cases, and the selected period was from August 2017 to September 2018. The subjects were divided into two groups, cerebral hemorrhage group and cerebral infarction group, and DTI scans were given to the two groups to measure the ipsilateral CST of the lesion and the opposite side of the lesion corre- sponding brain tissue value (FA). Meanwhile, fugl-meye motor function score (FMA) was used to evaluate the motor function of the patients with hemiplegia. Results Two groups of patients with lesions of ipsilateral FA values are lower than the contralateral FA value of symmetric parts of brain tissue (P<0.05), cerebral infarction group lesion ipsilateral focal cerebral peduncle, corona radiata area, internal capsule hind limbs and primary cortical motor area and FA values, rFA values, FAasy value is closely related to the FMA score (P<0.05), cerebral hemorrhage group lesion ipsilateral cerebral peduncle, corona radiata area, FA values of internal capsule posterior layer, rFA, FAasy value is closely related to the FMA score (P< 0.05). Conclusion Diffusion tensor magnetic resonance imaging can effectively evaluate the correlation between cortical spinal cord injury and motor function after stroke.