Cheng Chun-Yu, Hsu Chia-Yu, Huang Yen-Chu, Tsai Yuan-Hsiung, Hsu Hsien-Ta, Yang Wei-Husn, Lin Hsiu-Chu, Wang Ting-Chung, Cheng Wan-Chun, Yang Jen-Tsung, Lee Tao-Chen, Lee Ming-Hsueh
Neurol Res. 2015 Sep;37(9):774-81. doi: 10.1179/1743132815Y.0000000050. Epub 2015 May 25.
Although diffusion tensor imaging (DTI) is widely studied to assess the motor outcome after ischaemic stroke, there is paucity of data regarding outcomes of intracerebral haemorrhage (ICH). The aim of this study was to determine the DTI data from different locations along the corticospinal tract (CST) and association to motor outcome.
We prospectively recruited patients with deep ICH admitted to our hospital from November 2010 to July 2012.Diffusion tensor imaging was performed within 14 days after the onset of ICH. Fractional anisotropy (FA) was measured along the CST at corona radiata, perihaematomal oedema, cerebral peduncle and pons. Corticospinal tract integrity was classified into three types by diffusion tensor tractography (DTT): type A with preserved CST, type B with partially interrupted CST and type C with completely interrupted CST. Motor outcome was assessed by Motricity index (MI) at admission, after 1 and 3 months.
Forty-eight patients were enrolled with a mean age of 62 years. The median time interval from onset of ICH to DTI study was 7 days. The patients in type C had significantly worse MI at admission (P < 0.001), after 1 month (P < 0.001) and after 3 months (P < 0.001) as compared to those with type A and type B. Lower rFA at the corona radiata was significantly correlated with poorer motor outcome at admission, after 1 month and after 3 months.
Clinical motor outcome of ICH within 2 weeks can be identified with a statistically significant decrease in rFA at the corona radiata.
尽管弥散张量成像（DTI）已被广泛用于评估缺血性中风后的运动结局，但关于脑出血（ICH）结局的数据却很少。本研究的目的是确定沿皮质脊髓束（CST）不同位置的DTI数据及其与运动结局的关系。
我们前瞻性招募了2010年11月至2012年7月入住我院的深部ICH患者。在ICH发病后14天内进行弥散张量成像。在放射冠、血肿周围水肿、脑桥和脑桥处沿CST测量分数各向异性（FA）。通过弥散张量纤维束成像（DTT）将皮质脊髓束完整性分为三种类型：A型为CST保留，B型为CST部分中断，C型为CST完全中断。在入院时、1个月和3个月后通过运动功能指数（MI）评估运动结局。
共纳入48例患者，平均年龄62岁。从ICH发病到DTI研究的中位时间间隔为7天。与A型和B型患者相比，C型患者在入院时（P<0.001）、1个月后（P<0.001）和3个月后（P<0.001）的MI明显更差。放射冠处较低的相对FA与入院时、1个月和3个月后较差的运动结局显著相关。
在2周内，ICH的临床运动结局可通过放射冠处相对FA的统计学显著降低来确定。
