DTI和FT在急性脑卒中诊断及治疗中的价值分析

The Value of DTI and FT in the Diagnosis and Treatment of Acute Stroke

目的:探讨磁共振扩散张量成像(DTI)和磁共振纤维束示踪(FT)在急性脑卒中(CS)患者中的应用价值。方法:选取2021年12月至2022年12月本院收治的70例CS患者,进行弥散加权成像(DWI)、DTI扫描和FT图像重建。检测患侧感兴趣区(ROI)、健侧各向异性分数(FA)和信号强度计算弥散系数(ADC);比较患侧与健侧DWI和DTI扫描的ADC值;比较患侧ROI区与健侧DTI参数;采用美国国立卫生院卒中量表(NHISS)评分和改良Rankin量表(MRS)评分评估患者神经功能缺损情况;Pearson检验相关性分析CS患者患侧DTI参数与神经功能缺损评估指标的相关性。结果:CS患者病灶区DTI扫描和FT重建图像表现为神经纤维方向及位置改变和FA值下降;CS患者DWI扫描中患侧与健侧的ADC值均明显高于DTI扫描结果(P<0.05);患侧FA值和ADC值等DTI参数均明显低于健侧(P<0.05);Pearson检验相关性分析显示,患侧FA值、ADC值等DTI参数与NHISS评分、MRS评分等神经功能缺损评估指标均呈负相关(P<0.05)。结论:DTI参数测定结合FT图像重建可从影像学角度直观显示并定量分析CS神经纤维损害程度,有助于判断患者神经功能缺损程度。

Objective:To explore the application value of magnetic resonance diffusion tensor imaging(DTI)and magnetic resonance fiber tracking(FT)in patients with acute cerebral stroke(CS).Methods:A total of 70 patients with CS admitted to the hospital were enrolled between January 2019 and January2021.All underwent diffusion-weighted imaging(DWI),DTI scan and FT image reconstruction.The region of interest(ROI)at affected side,fractional anisotropy(FA)at healthy side and signal intensity were detected to calculate apparent diffusion coefficient(ADC).ADC values at affected side and healthy side under DWI and DTI scans,ROI at affected side and DTI parameters at healthy side were compared.The neurological deficits were assessed by scores of National Institutes of Health Stroke Scale(NHISS)and Modified Rankin Scale(MRS).The correlation between DTI parameters at affected side and neurological deficit indexes was analyzed by Pearson correlation analysis.Results:DTI scans and FT reconstruction images at lesion area in CS patients showed there were changes in the direction and sites of nerve fibers,and decreased FA.ADC values at affected side and healthy side under DWI scans were significantly greater than those under DTI scans(P<0.05).FA and ADC at affected side were significantly lower than those at healthy side(P<0.05).Pearson correlation analysis showed that FA and ADC at affected side were negatively correlated with NHISS and MRS scores(P<0.05).Conclusion:DTI parameters detection combined with FT images reconstruction can intuitively display and quantitatively analyze the severity of nerve fiber damage in CS from the point of imaging,which is beneficial to determine the degree of neurological deficits.