磁共振扩散张量成像量化参数在创伤性脑白质损伤中的联合应用

Clinical Application of Magnetic Resonance Diffusion Tensor Imaging in Traumatic White Matter Injury

目的多个量化参数联合应用评价磁共振扩散张量成像(DTI)在创伤性脑白质损伤(TWMI)中的作用。方法收集20例经临床明确的TWMI患者使用联影uMR7703T磁共振行常规MRI与DTI检查,另选取20例正常人作为对照组。选取5个感兴趣区,分别为胼胝体膝部及压部、伤侧内囊前肢及后肢、伤侧上纵束,经工作站后处理获取表观弥散系数图(ADC图)、各向异性指数图(FA图)和3D纤维束成像图(DTT)。对两组数据进行统计学分析。结果TWMI组在胼胝体膝部(GCC)与压部(SCC)、内囊前肢(AIC)与后肢(PIC)部位ADC值相对于对照组均升高,差异有统计学上意义(P<0.05),在半卵圆中心(SC)部位P>0.05,无显著性差异。两组各部位的FA值经独立样本t检验表明,全部5个感兴趣区FA值相对于对照组均降低,差异具有统计学意义(P<0.05)。DTT成像显示受伤区白质比正常部分明显分离、稀疏或缺损。结论综合运用DTI技术可有力协助评价TWMI患者严重性以及预后如何。

Objective To evaluate the value of magnetic resonance diffusion tensor imaging(DTI)in traumatic white matter injury(TWMI).Methods Twenty patients with clinically diagnosed TWMI after traumatic brain trauma were examined by the uMR7703T magnetic resonance scanner,and twenty normal persons as the control part.Five interested regions were selected,the gneu of corpus callosum(GCC)and the splenium(SCC)、the Anterior limb and posterior limb of internal capsule of the injured side(AIC、PIC),and the center of a semiovale(SC),the partial anisotropy index(FA)、apparent diffusion coefficient(ADC)、3D diffusion tensor tractography(3D-DTT)were obtained by post-processing of the workstation.Statistical analysis of both sets of data.Results lower ADC values were seen in the TWMI group in GCC、SCC、AIC、PIC relative to the control group,and the difference was statistically significant(P<0.05),no significant differencein the upper longitudinal tract(SLB)site(P>0.05).The FA values of each site in the two groups were analyzed by the independent sample t-test,and the FA values of all five ROI decreased relative to the control group,and the difference was statistically significant(P<0.05).DTT shows that the white matter in the injured area is partially sparse,isolated,or absent than the normal area.Conclusion DTI technology can be used as a powerful tool to assess the severity and prognosis of patients with TWMI.