脑卒中患者磁共振弥散张量成像检查皮质脊髓束与下肢肌力恢复的关系

目的研究磁共振弥散张量成像(DTI)检查病变侧脑皮质脊髓束(CST)的修复与下肢肌力恢复的关系。方法选择32例脑卒中患者,入院时及康复治疗2个月后,分别进行肌力评级及DTI检查,并重建患者双侧CST的3D纤维图,分析康复治疗前后患者DTI与下肢肌力变化的关系。结果患者治疗后CST的部分各向异性(FA)值和CST分级及肌力较治疗前有显著提高(P<0.05)。CST未完全中断者治疗后下肢肌力恢复较好,CST完全中断者肌力恢复较差。治疗前后病变侧FA值及CTS分级与肌力评级均呈正相关(r=0.756,0.751,P=0.001;r=0.750,0.748,P=0.002)。结论应用DTI检查CST可评估脑卒中患者下肢肌力恢复预后。

Role of DTI in demonstrating the relation between lateral CST repair and lower limb muscle strength recovery in IS patients

Objective To study the role of DTI in demonstrating the relation between lateral corticospinal tract(CST)repair and lower limb muscle strength recovery in IS patients.MethodsThirty-two IS patients were included in this study.Their lower limb muscle strength was assessed on admission and 2months after rehabilitation according to their DTI.A bilateral CST 3-dimensional fiber figure was established.The relation between CST and lower limb muscle strength was analyzed before and after rehabilitation.Results The FA value,CST grade,and lower limb muscle strength were significantly higher in IS patients after rehabilitation than before rehabilitation(P<0.05).The recovery of lower limb muscle strength was better in patients with their CST incompletely interrupted than in those with their CST completely interrupted.The FA value and CST grade were positively related with the injured CST side before and after rehabilitation(r= 0.756,r=0.751,P=0.001;r=0.750,r=0.748,P=0.002).Conclusion The recovery of lower limb muscle strength can be assessed according to DTI-demonstrated CST in IS patients.