Han Bong Soo, Ahn Sang Ho, Jang Sung Ho
Department of Radiation Science, Yonsei University College of Health Science, Kangwon-do, Republic of Korea.
NeuroRehabilitation. 2008;23(2):171-4.
The diffusion tensor tractography (DTT) allows the corticospinal tract(CST) to be visualized at the subcortical level and functional MRI (fMRI) is capable of precisely identifying activation sites at the cortex. Therefore, it seems that combined DTT/fMRI would allow more accurate evaluation of the state of the CST. We have attempted to demonstrate cortical reorganization in a patient with cortical hemorrhage using DTT analyzed by fMRI activations. Six normal subjects and a 12-year-old female patient with a hemorrhage in the left fronto-parietal cortex were recruited. fMRI was performed at 1.5-T with timed hand grasp-release movements, and DTT was performed using 1.5-T with a Synergy-L Sensitivity Encoding head coil. Three-dimensional reconstructions of the fiber tracts were obtained using the fMRI activation as the seed region of interest and the CST area of the anterior pons as the target region of interest. The tract of the affected hemisphere originated from the lateral area of the injured precentral knob and descended along the known corticospinal tract pathway. It seems that the motor function of the affected hand was reorganized into the lateral area of the injured precentral knob. Therefore, these combined modalities would be helpful in elucidating the state of the CST.
扩散张量纤维束成像（DTT）能够在皮质下水平显示皮质脊髓束（CST），而功能磁共振成像（fMRI）能够精确识别皮质的激活位点。因此，联合使用DTT/fMRI似乎可以更准确地评估CST的状态。我们试图通过fMRI激活分析的DTT来证明一名皮质出血患者的皮质重组情况。招募了6名正常受试者和一名12岁左侧额顶叶皮质出血的女性患者。使用1.5-T设备进行fMRI检查，同时进行定时的手部抓握-松开动作，使用1.5-T设备和Synergy-L敏感编码头线圈进行DTT检查。以fMRI激活作为感兴趣的种子区域，脑桥前部的CST区域作为感兴趣的目标区域，获得纤维束的三维重建图像。患侧半球的纤维束起源于受伤的中央前回隆起的外侧区域，并沿着已知的皮质脊髓束路径下行。似乎患侧手的运动功能重新组织到了受伤的中央前回隆起的外侧区域。因此，这些联合方式将有助于阐明CST的状态。
