Son Su Min, Ahn Young Hwan, Sakong Joon, Moon Han Ku, Ahn Sang Ho, Lee Ho, Yu In Kyu, Shin Youn Jeong, Jang Sung Ho
Department of Physical Medicine and Rehabilitation, School of Medicine, Eulji University, Daejeon, Republic of Korea.
Neurosci Lett. 2007 Jun 8;420(1):34-8. doi: 10.1016/j.neulet.2007.04.054. Epub 2007 Apr 27.
The purpose of this study was to use diffusion tensor imaging (DTI) with fiber tractography (FT) to demonstrate focal lesions of the corticospinal tract (CST) in hemiparetic patients with cerebral palsy (CP) who showed no specific focal lesions on conventional brain MRI. Four hemiparetic patients with CP (three left hemiparesis, mean age: 2.5 years, range: 0.9-7.0) and four age-matched controls were recruited. DTI was performed using a 1.5-T system with a synergy-L Sensitivity Encoding head coil. Fractional anisotropy (FA) and apparent diffusion coefficients (ADC) were measured using the region of interest (ROI) method. We estimated the asymmetric anisotropy index (AA) and asymmetric mean diffusivity index (AD) to evaluate the asymmetry between right and left CSTs. All four patients showed interrupted FT at the affected periventricular white matter (PVWM) level compared to that of the opposite side; this was not detected on conventional brain MRI and explained the hemiparesis of these patients. Compared to the data of controls, all patients showed significant AA and AD only at the PVWM level. DTI with FT demonstrated focal lesions at the PVWM level. We conclude that DTI with FT may be a useful modality for investigating focal lesions in hemiparetic patients with CP.
本研究的目的是使用扩散张量成像（DTI）结合纤维束示踪（FT）技术，来显示在常规脑MRI上未发现特定局灶性病变的脑性瘫痪（CP）偏瘫患者的皮质脊髓束（CST）局灶性病变。招募了4名CP偏瘫患者（3名左侧偏瘫，平均年龄：2.5岁，范围：0.9 - 7.0岁）和4名年龄匹配的对照者。使用配备Synergy-L灵敏度编码头部线圈的1.5-T系统进行DTI检查。采用感兴趣区（ROI）法测量分数各向异性（FA）和表观扩散系数（ADC）。我们估算了不对称各向异性指数（AA）和不对称平均扩散率指数（AD），以评估左右CST之间的不对称性。与对侧相比，所有4例患者在患侧脑室周围白质（PVWM）水平均显示纤维束中断；这在常规脑MRI上未被检测到，解释了这些患者的偏瘫情况。与对照组数据相比，所有患者仅在PVWM水平显示出显著的AA和AD。DTI结合FT显示了PVWM水平的局灶性病变。我们得出结论，DTI结合FT可能是研究CP偏瘫患者局灶性病变的一种有用方法。
