急慢性出血性脑卒中患者受损皮质脊髓束磁共振弥散张量成像特点分析

目的:探究急慢性出血性脑卒中患者受损皮质脊髓束磁共振成像(MRI)的弥散张量成像(DTI)特点分析。方法:选取60例出血性脑卒中患者,依据诊断结果将其分为急性出血性脑卒中组(急性组,21例)和慢性出血性脑卒中组(慢性组,39例)。对两组患者进行DTI扫描,测量病变侧皮质脊髓束、病变对侧分数各向异性(FA)值及平均弥散率(MD)。结果:两组病灶同侧大脑脚、内囊后肢、放射冠区、初级皮质运动区域FA值均低于对侧对称部位脑组织,两组比较差异具有统计学意义(t=6.927,t=8.745,t=5.683;t=4.316;P<0.05);两组大脑脚、内囊后肢、放射冠区、初级皮质运动区域MD值比较,病灶同侧均低于对侧对称部位脑组织,差异有统计学意义(t=4.216,t=6.027,t=7.653,t=5.964;P<0.05);两组病灶同侧大脑脚、放射冠区、内囊后肢以及初级皮质运动均与FA值具有一定的相关性(r=0.724,r=0.798,r=0.713,r=0.687;P<0.05)。结论:磁共振DTI能够有效评估急慢性出血性脑卒中患者受损皮质脊髓束与肢体运动功能的相关性,具有重要的临床意义。

Analysis on MRI DTI of damaged corticospinal tract of patients with acute and chronic hemorrhagic stroke

Objective:To explore and analyze the characteristics of magnetic resonance imaging(MRI)diffusion tensor imaging(DTI)of damaged corticospinal tract of patients with acute and chronic hemorrhagic stroke.Methods:60 patients with hemorrhagic stroke admitted to hospital were selected as the research objects,and they were divide into two groups according to diagnostic results,and acute hemorrhagic stroke group included 21 cases and chronic hemorrhagic stroke group included 39 cases.Diffusion tensor imaging(DTI)scans were performed on the patients of two groups to measure the corticospinal tract on the side of lesion,the contralateral fractional anisotropy(FA)value of the lesion and the mean diffusivity(MD).Results:For two groups,the FA values of ipsilateral cerebral peduncle,posterior limb of internal capsule,radiate corona region and primary cortex movement region of lesion were significantly lower than those of the brain tissue of contralateral symmetric position(t=6.927,t=8.745,t=5.683,t=4.316,P<0.05).And the MD values of above positions of lesion were significantly lower than those of the brain tissue of contralateral symmetric position(t=4.216,t=6.027,t=7.653,t=5.964,P<0.05).For two groups,the lesions of ipsilateral cerebral peduncle,posterior limb of internal capsule,radiate corona region and primary cortex movement region has a certain of correlation with FA value(r=0.724,r=0.798,r=0.713,r=0.687,P<0.05).Conclusion:MRI DTI can effectively assess the correlation between damaged corticospinal tract and limb movement function in patients with acute and chronic hemorrhagic stroke,and it has important clinical significance.