磁共振弥散成像联合弥散张量纤维束成像技术对老年脑梗死患者的疾病评估价值分析

Analysis of the value of diffusion tensor imaging combined with diffusion tensor tractograghy in disease evaluation of elderly patients with cerebral infarction

目的观察分析磁共振弥散成像(DTI)联合弥散张量纤维束成像技术(DTT)技术对老年脑梗死患者的疾病评估价值。方法选取2016年12月至2017年12月于该院治疗的脑梗死老年患者45例,患者治疗前均进行DTI和DTT成像,根据皮质脊髓束(CST)与脑梗部位的相对位置(相邻、穿过、部分穿过),将所有患者预测分为瘫痪组、部分恢复组及恢复组;患者入院时采用美国国立卫生院脑卒中量表(NIHSS)评价脑梗死的严重程度,根据患者评分情况,将所有患者预测分为瘫痪组、部分恢复组及恢复组。将不同方法的分组预测情况分别与患者实际值进行比较分析,并分析预测值与实际值之间的关系。结果NIHSS预测分组:恢复组9例中有4例恢复,占44.44%;部分恢复组15例中有6例部分恢复,占40.00%;瘫痪组21例中有10例瘫痪,占47.62%;3组预测值与实际值比较,差异均有统计学意义(P<0.05)。通过CST与脑梗部位的位置预测分组:恢复组13例中有12例恢复,占92.31%;部分恢复组17例中有15例部分恢复,占88.24%;瘫痪组14例中有13例瘫痪,占92.86%;预测值与实际值比较,差异均无统计学意义(P>0.05)。两类方法在各组间的预测值与实际值符合率比较,差异均有统计学意义(P<0.05)。结论与NIHSS评分预测患者疾病评估相比,通过DTI和DTT成像评估患者疾病准确性更高,因此DTI联合DTT对老年脑梗死患者的疾病评估更具有临床价值。

Objective To analyse the value of diffusion tensor imaging(DTI)combined with diffusion tensor tractograghy(DTT)in disease evaluation of elderly patients with cerebral infarction.Methods A total of 45 elderly patients with cerebral infarction treated in the hospital from December 2016 to December 2017 were selected.All patients were subjected to DTI and DTT imaging before treatment.According to the relative position between the cortico-spinal tract(CST)and cerebral infarction(adjacent,crossed,partially penetrated),all patients were predicted to be divided into the paralysis group,the partial recovery group and the recovery group.When patients were admitted to this hospital,the National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the severity of cerebral infarction and all patients were predicted to be divided into the paralysis group,the partial recovery group,and the recovery group according to the patients's score.The predicted values of each group of different methods were compared with the actual values of the patients,and the relationship between the predicted values and the actual values was analyzed.Results NIHSS prediction grouping:4 of the 9 patients in the recovery group recovered,accounting for 44.44%;6 of the 15 patients in the partial recovery group recovered partially,accounting for 40.00%;10 of 21 patients in the paralyzed group were paralyzed,accounting for 47.62%;the differences between the predicted value and the actual value in the three groups were statistically significant(P<0.05).Prediction grouping by relative position between CST and cerebral infarction:12 of the 13 patients in the recovery group recovered,accounting for 92.31%;15 of 17 patients in the partial recovery group recovered partially,accounting for 88.24%;13 of 14 patients in the paralyzed group were paralyzed,accounting for 92.86%;there was no significant difference between the predicted values and the actual values in the three groups(P>0.05).There was statistically significant difference in the coincidence rate of the predicted value and the actual value between the two methods in each group(P<0.05).Conclusion Compared with evaluating the patient's disease by the NIHSS score,DTI and DTT imaging are more accurate.Therefore,DTI combined with DTT has more clinical value in the disease assessment of elderly patients with cerebral infarction.