磁共振扩散张量纤维束成像对基底节区脑出血后运动功能预后的预测价值

Evaluation of the value of motor function recovery in patients with basal ganglia hemorrhage with diffusion tensor tractography

目的探讨磁共振扩散张量纤维束成像(DTT)对基底节区脑出血后皮质脊髓束(CST)损伤程度及对运动功能预后的预测价值。方法采用磁共振对36例急性基底节区脑出血、急性内囊后肢脑出血患者进行扩散张量成像(DTI)检查,应用DTT技术进行CST三维重建,由软件计算获得患侧的剩余CST条目数,用于评价患侧CST内囊后肢锥体束的受累程度;同时于患者发病3个月后采用Fugl-Meyer评分进行运动功能评价,探讨剩余CST条目数与脑出血后运动功能预后的相关性。结果患者患侧的相对剩余CST条目数与3个月后F-M评分之间具有较高的相关性(r=0.928,P<0.01)。结论基底节区脑出血患者患侧剩余CST条目数与运动功能损伤程度相关。利用DTT可在脑出血的早期对急性基底节区脑出血患者运动功能3个月的预后进行预测评估。

Objective To investigate the predicting value of magnetic resonance imaging diffusion tensor tractography(DTT)on the degree of corticospinal tract(CST)injury after basal ganglia hemorrhage and the motor function recovery.MethodsDiffusion tensor imaging(DTI)was performed on 36 patients with acute basal ganglia hemorrhage or acute intracapsular hindlimb intracerebral hemorrhage using magnetic resonance imaging. DTT technology was used for CST three-dimensional reconstruction,and the remaining number of CST on the affected side was calculated by software. The remaining number of CST was applied to evaluate the degree of involvement of the posterior pyramidal tract of the internal capsule of the affected side of the CST;the motor function of the patient 3 months after the onset was assessed simultaneously by the Fugl-Meyer score to explore the correlation between the remaining number of CST and the motor function recovery after cerebral hemorrhage.ResultsThe remaining number of CST on the affected side was significantly associated with the F-M score after 3 months(r=0.928,P<0.01).ConclusionThe remaining number of CST on the affected side of patients with basal ganglia cerebral hemorrhage is related to the degree of motor function impairment;DTT could be used to predict the3-month prognosis of patients with acute basal ganglia cerebral hemorrhage in the early stage of cerebral hemorrhage.