磁共振弥散张量成像研究脑桥梗死后神经纤维华勒变性及临床意义

目的探讨磁共振弥散张量成像技术对于脑桥梗死后华勒变性的临床诊断价值。方法采集2008年6月至2011年12月确诊的发生脑桥梗死的患者50例，所有患者均在发病第1周（5．0±2．0d）内分别采用常规MRI方法和磁共振弥散张量成像技术进行检查，对比检查结果。结果常规的MRI检查结果显示50例脑桥梗死患者的阳性率（62．0％）低于共振弥散张量成像技术显示的阳性率（94．0％），两者之间有显著的统计学差异（P〈0．05）；磁共振弥散张量成像技术检查出的47例阳性病例，其患侧大脑脚和脑桥基底部的FA均值均比健侧低，差异均有统计学意义（P〈0．05）。结论共振弥散张量成像技术相对于常规的MRI，对于华勒变性的诊断更加敏感和准确。两者联合应用，可提高对活体脑桥梗死后华勒变性的诊断的准确性。

Clinical significance of magnetic resonance diffusion tensor imaging for Wallerian degeneration after pontine infarction

Objective To investigate the diagnostic value of magnetic resonance diffusion tensor imaging （MRDTI） for Wallerian degen- eration after pontine infarction. Methods Fifty cases of pontine infarction diagnosed between April 2010 and June 2011 were retrospectively ana- lyzed. All patients were examined with either conventional MRI or MRDTI in the first week （5 ＋ 2 d） after the onset of the disease. The two exam- ination results were compared. Results MRDTI examination showed that 47 of 50 cases were found with Wallerian degeneration ; the positive rate was significantly higher than that by conventional MRI examination （ P 〈 0.05 ）. In addition, the mean FA value in cerebral peduncle and basilar part of pons in diseased side was lower than that in healthy side （ P 〈 0.05 ）. Conclusion MRDTI is more sensitive and accurate than conven- tional MRI for the diagnosis of Wallerian degeneration. The combined use of the two techniques may improve the diagnosis of Wallerian degenera- tion after pontine infarction.