磁共振血氧水平依赖法对评价缺血性脑卒中患者短期预后的研究

目的探讨磁共振血氧水平依赖(Bold)法对脑卒中患者短期康复预后评价的意义。方法选择30例脑卒中患者行功能磁共振Bold法检查,研究它与脑卒中短期预后的关系。结果Brunnstrom Ⅰ或Ⅱ级的患者在患手被动和主动运动中,表现为偏瘫同侧单侧感觉运动区激活的有5例,康复治疗3周后仍为Ⅱ级,1例双侧感觉运动区激活的患者3周后恢复为Ⅲ级。Brunnstrom Ⅲ或Ⅳ级的患者有5例为单侧激活,康复治疗3周无变化,而双侧激活的9例在康复治疗3周后,3例为Ⅵ级,6例为Ⅴ级。Brunnstrom Ⅴ级和Ⅵ级患者均为双侧感觉运动区激活,康复3周后,Brunnstrom分级为Ⅴ级4例中的2例恢复Ⅵ级,2例恢复为正常。而Ⅵ级6例中有5例恢复为正常,1例恢复仍为Ⅵ级。结论偏瘫Bold法显示双侧激活的患者,短期内康复效果明显,脑皮质激活区为同侧激活者在短期内康复预后差。

Blood oxygenation level-dependent functional MRI for prediction of short-term outcome of stroke patients

Objective To study prediction of short-term outcome of stroke patients with blood oxygenation level-dependent(Bold) functional MRI.Methods Thirty cases of hemiplegia with stroke were examined with Bold functional MRI.The relationship between short-term outcome and cerebral cortex activation of active and passive clenching of paralytic hand was analyzed.Results In Brunnstrom grade Ⅰ or Ⅱ grade patients,5 cases showed ipsilateral sensorimotor cortex activation(SMA) and were still in Brunnstrom grade Ⅱ after three weeks of rehabilitation,but one case showing bilateral SMA became Brunnstrom grades Ⅲ and Ⅴ after three weeks and one month of rehabilitation.In Brunnstrom grade Ⅲ or Ⅳ patients,5 cases showed ipsilateral SMA and had no change after three weeks of rehabilitation,while of 9 cases showing bilateral SMA,3 became Brunnstrom grade Ⅵ and 6 became Brunnstrom grade Ⅴ after three weeks.Four cases of Brunnstrom grade Ⅴ and 6 cases of Brunnstrom grade Ⅵ showed bilateral SMA,among them,2 cases of Brunnstrom grade Ⅴ became Brunnstrom grade Ⅵ after three weeks of rehabilitation,another 2 cases became normal.Five Brunnstrom grade Ⅵ patients recovered completely,one case was still in Brunnstrom grade Ⅵ after three weeks of rehabilitation.Conclusion Bold examination plays an important role in prediction of short-term outcome of stroke patients.There is better outcome in bilateral SMA than in ipsilateral SMA.