脑出血患者损伤皮质脊髓束的命运：弥散张量成像研究。
The fate of injured corticospinal tracts in patients with intracerebral hemorrhage: diffusion tensor imaging study.
机构信息
Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Republic of Korea.
出版信息
AJNR Am J Neuroradiol. 2012 Oct;33(9):1775-8. doi: 10.3174/ajnr.A3027. Epub 2012 Apr 5.
BACKGROUND AND PURPOSE
Little is known about the fate of the injured CST for a large number of patients with ICH. Using DTT, we investigated the longitudinal changes of injured CSTs in patients with an ICH.
MATERIALS AND METHODS
We recruited 45 patients with CST injury by an ICH in the supratentorial subcortical area. Two longitudinal DTTs were acquired: 1 within 30 days and the other after 3 months from onset. DTTs for the CST were classified into 3 types: type A, the CST was preserved around the hematoma; type B, the CST was interrupted around the hematoma; and type C, the CST did not reach the hematoma.
RESULTS
At the first DTT, the motor functions of type C were worse than those of types A and B (P < .01), and motor functions of type A were better than those of type C at the second DTT (P < .01). Of 14 type A, 2 changed to type B (14.3%) and 12 did not change (85.7%); of 12 type B, 11 changed to type A (91.7%) and 1 changed to type C (8.3%); of 19 type C, 3 changed to type A (15.8%) and 16 did not change (84.2%).
CONCLUSIONS
We found that the injured CST could change from the early stage to the chronic stage during the motor recovery phase in patients with an ICH. These results would be helpful in prediction of longitudinal DTT changes from the early stage to the chronic stage following ICH.
背景与目的
对于大量的脑出血（ICH）患者，其损伤的皮质脊髓束（CST）的命运知之甚少。我们使用弥散张量成像（DTT）技术，研究了ICH 患者 CST 的纵向变化。
材料与方法
我们招募了 45 例皮质下区幕上ICH 导致 CST 损伤的患者。进行了 2 次纵向 DTT 检查：1 次在发病后 30 天内，另 1 次在发病后 3 个月。将 CST 的 DTT 分为 3 种类型：A 型，CST 环绕血肿保留；B 型，CST 在血肿周围中断；C 型，CST 未到达血肿。
结果
在第 1 次 DTT 时，C 型的运动功能较 A 型和 B 型差（P<0.01），而在第 2 次 DTT 时，A 型的运动功能较 C 型好（P<0.01）。14 例 A 型中，2 例（14.3%）转变为 B 型，12 例（85.7%）未改变；12 例 B 型中，11 例（91.7%）转变为 A 型，1 例（8.3%）转变为 C 型；19 例 C 型中，3 例（15.8%）转变为 A 型，16 例（84.2%）未改变。
结论
我们发现，在脑出血患者的运动恢复阶段，损伤的 CST 可从早期转变为慢性期。这些结果有助于预测脑出血后从早期到慢性期的纵向 DTT 变化。
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