弥漫性轴索损伤早期磁共振弥散张量成像检测与恢复期注意力障碍的相关性研究

目的应用磁共振弥散张量成像技术研究患者早期弥漫性轴索损伤(DAI)与恢复期时注意力障碍之间的关系。方法分别对12例DAI患者(伤后4.1±1.7d)和10例健康志愿者(正常对照组)进行MRI弥散张量成像(DTI)检查及神经心理测评量表评估。使用感兴趣区域方法对两组DTI图像的下纵束、上纵束、胼胝体膝部和胼胝体压部的FA值进行比较;分别对恢复期的DAI患者(20.9±7.3 M)与健康志愿者行认知量表评估,并对DAI组的FA值与神经心理测评量表的总分行pearson直线相关分析。结果与健康对照组相比,DAI患者全部感兴趣区的FA值显著降低(P<0.05)、注意力功能显著降低(P<0.05)。DAI患者中的上纵束和下纵束与注意力量表总分呈负性相关(P<0.05),胼胝体膝部和胼胝体压部与注意力量表总分无相关性(P>0.05)。结论利用DTI技术检测早期白质纤维束的损伤可以预测DAI患者在恢复期中的注意力功能障碍,为临床上DAI患者的认知障碍的诊断提供一定的科学依据。

Detection of white matter lesions using MRI diffusion tensor imaging in the acute stage of diffuse axonal injury predicts long-term attention impairments.

Objective To evaluate the relationship between white matter integrity during the early post-injury stage and attention function over the long term using diffusion tensor imaging(DTI).Methods DTI was performed in 12 DAI patients within 7 days of injury and in 10 controls.Fractional anisotropy(FA) was calculated within regions of interest(ROI),including superior longitudinal fasciculus(SLF),inferior longitudinal fasciculus(ILF),genu of the corpus callosum(gCC) and splenium of the corpus callosum(sCC).DAI patients and controls also underwent neuropsychological testing during the long term post-DAI stage.Results The ROI analysis showed significantly reduced FA value in all 4 regions within 7 days of injury compared to controls.In addition,the patients demonstrated significantly poorer performance on the attention test than did members of the control group.In patients with DAI,attention function was inversely correlated with the FA value in the ILF and SLF.Conclusion Results showed white matter changes at early stage in patients with DAI as detected by diffusion tensor imaging may be helpful in predicting cognitive dysfunction in the chronic stage.