基于DTI成像研究脑梗死后单侧运动通路损伤的大脑结构改变

Study on the Changes of Brain Structure of Unilateral Motor Pathway Injury after Cerebral Infarction Based on DTI Imaging

目的:探讨单侧运动通路受损脑梗死患者大脑结构的改变。方法:选择单侧运动通路受损的脑梗死患者66例,匹配性别、年龄相当的健康受试者66例。采用3.0 T磁共振扫描仪对所有受试者行DTI序列的扫描。采用基于纤维束示踪的空间分析方法(TBSS)对两组脑图像进行处理,比较脑梗死受试者组和健康受试者组在大脑结构上的不同。结果:和健康受试者相比,脑梗死受试者的胼胝体FA值明显降低的脑区为胼胝体膝部、胼胝体体部;双侧FA值降低的相关脑区为双侧放射状前冠、双侧上放射冠;患侧FA值降低的相关脑区为皮质脊髓束、大脑脚、内囊前脚、内囊后脚、内囊豆状核后部、后放射冠、丘脑后放射冠(包括视辐射)、外囊、上纵束、额枕上束和右侧绒毡层(P<0.001)。结论:单侧运动通路损伤后大脑的结构出现双侧性变化,其中枢神经机制可能是胼胝体纤维受损;患侧除了运动相关脑白质纤维结构受损,非运动相关的脑白质纤维同样会受到影响。

Objective: To explore the changes of brain structure in patients with cerebral infarction with unilateral motor pathway damage. Methods: 66 Patients with cerebral infarction with unilateral motor pathway impairment were selected, and 66 healthy subjects of the same sex and age were matched. All subjects were scanned with DTI sequence by3.0 T magnetic resonance scanner. TBSS was used to process the brain images of the two groups, and the differences in brain structure between the cerebral infarction group and the healthy group were compared. Results: Based on TBSS, the FA values of all stroke hemiplegic subjects and healthy subjects were obtained by processing DTI data. The results showed that compared with healthy subjects, the brain areas with significantly decreased in FA value of corpus callosum in subjects with cerebral infarction including: genu of corpus callosum, body of corpus callosum;the bilateral brain areas with significantly decreased in FA value including: anterior corona radiate, anterior corona radiate, superior corona radiate;ipsilateral brain areas with significantly reduced FA value: corticospinal tract, cerebral peduncle, anterior limb of internal capsule, posterior limb of internal capsule, retrolenticular part of internal capsule, superior corona radiate, posterior corona radiate, posterior thalamic radiation, external capsule, superior longitudinal fasciculus, superior fronto-occipital fasciculus,and tapetum(P<0.001). Conclusion: After unilateral motor pathway stroke, the structure of the brain changes bilaterally.The mechanism of structural damage in the contralateral brain region may be the damage of unaffected corpus callosum fibers;in addition to the damage of movement related white matter fiber structural, the non movement related white matter fiber will also be affected.