Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Hyogo; Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine, Nishinomiya, Hyogo.
J Stroke Cerebrovasc Dis. 2013 Nov;22(8):1355-60. doi: 10.1016/j.jstrokecerebrovasdis.2013.02.017. Epub 2013 Mar 17.
This study examined the relationship between fractional anisotropy (FA) values of magnetic resonance-diffusion tensor imaging (DTI) and motor outcome (1 month after onset) in 15 patients with hemiparesis after ischemic stroke of corona radiata lesions. DTI data were obtained on days 14-18. FA values within the cerebral peduncle were analyzed using a computer-automated method. Motor outcome of hemiparesis was evaluated according to Brunnstrom stage (BRS; 6-point scale: severe to normal) for separate shoulder/elbow/forearm, wrist/hand, and lower extremity functions. The ratio of FA values in the affected hemisphere to those in the unaffected hemisphere (rFA) was assessed in relation to the BRS data (Spearman rank correlation test, P<.05). rFA values ranged from .715 to 1.002 (median=.924). BRS ranged from 1 to 6 (median=4) for shoulder/elbow/forearm, from 1 to 6 (median=5) for wrist/hand, and from 2 to 6 (median=4) for the lower extremities. Analysis revealed statistically significant relationships between rFA and upper extremity functions (correlation coefficient=.679 for shoulder/elbow/forearm and .706 for wrist/hand). Although slightly less evident, the relationship between rFA and lower extremity function was also statistically significant (correlation coefficient=.641). FA values within the cerebral peduncle are moderately associated with the outcome of both upper and lower extremity functions, suggesting that DTI may be applicable for outcome prediction in stroke patients with corona radiata infarct.
本研究探讨了 15 例大脑冠状辐射区梗塞后偏瘫患者弥散张量成像(DTI)各向异性分数(FA)值与发病 1 个月后运动结局(Brunnstrom 分期,6 分制:从严重到正常)之间的关系。DTI 数据于发病后第 14-18 天获得。使用计算机自动方法分析大脑脚内的 FA 值。偏瘫的运动结局根据肩/肘/前臂、腕/手和下肢功能的 Brunnstrom 分期(6 分制:严重至正常)进行评估。将患侧半球与健侧半球的 FA 值比(rFA)与 Brunnstrom 分期数据进行相关分析(Spearman 等级相关检验,P<.05)。rFA 值范围为 0.715-1.002(中位数为 0.924)。Brunnstrom 分期为肩/肘/前臂 1-6(中位数为 4),腕/手 1-6(中位数为 5),下肢 2-6(中位数为 4)。分析显示 rFA 与上肢功能之间存在显著的统计学相关性(肩/肘/前臂相关系数为 0.679,腕/手为 0.706)。虽然不太明显,但 rFA 与下肢功能之间也存在显著的统计学相关性(相关系数为 0.641)。大脑脚内的 FA 值与上肢和下肢功能的结局中度相关,表明 DTI 可能适用于冠状辐射区梗塞后卒中患者的结局预测。