Zou Z M, Li J, Cao Q Y, Lian H X, He C N, Wang B
Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264100, China.
Zhonghua Yi Xue Za Zhi. 2017 Jan 3;97(1):17-21. doi: 10.3760/cma.j.issn.0376-2491.2017.01.005.
To evaluate the clinical application value of diffusion tensor imaging (DTI) parameter in evaluating the prognosis of spinal cord injury in acute cervical spinal cord injury. From October 2012 to December 2015, a total of 23 patients with acute cervical spinal cord injury were examined by routine MRI-TWI high signal DTI examination, according to the American Spinal Injury Association (ASIA) damage standard. One month later according to the functional outcome of the spinal cord, all patients were divided into non improvement group (group A) 4 cases (2 cases of ASIA-A, 2 cases of grade B) and improvement group (group B) 19 cases (13 cases of ASIA-C, 5 cases of grade D, 1 case of grade B), 15 cases of healthy volunteers as the normal group (group C ). The FA value, ADC and axial eigen value[λ=λ1], radial eigen value[λ=(λ2+ λ3)/2]of before and after the treatment in group A and group B were compared by paired test respectively. Single factor analysis of variance () was used to analyze the differences of DTI among the group A, group B and group C, and test was used to compare the differences among the groups.Before and after treatment, the DTI measurement area was consistent.Changes of nerve fiber bundles in group A and group B before and after treatment were displayed in DTT. After the treatment , the FA value of group A decreased , ADC value and λ value increased than that of before treatment(=3.037, -4.183, -4.805, all <0.05), λ value increased(=-1.160, >0.05). After the treatment , the FA value and ADC value of group B increased , λ value decreased than that of before treatment(=-3.344, -3.642, 4.694, all <0.05), λ value increased(=-0.596, >0.05). After treatment, there were statistical differences in FA values, λ value , ADC values and λ values among three groups (=71.958, 70.432, 75.902, 22.521, all <0.01). The changes of FA value, λ value are the two most sensitive indicators of acute cervical spinal cord injury of spinal cord function prognosis.It suggests the poor prognosis of spinal cord function when FA value decreases and λ value continues to increase.DTT can visually display subtle changes in the nerve fiber bundle.
评估弥散张量成像（DTI）参数在评估急性颈髓损伤脊髓损伤预后中的临床应用价值。2012年10月至2015年12月，对23例急性颈髓损伤患者行常规MRI-TWI高信号DTI检查，依据美国脊髓损伤协会（ASIA）损伤标准。1个月后根据脊髓功能转归，将所有患者分为未改善组（A组）4例（ASIA-A级2例、B级2例）和改善组（B组）19例（ASIA-C级13例、D级5例、B级1例），选取15例健康志愿者作为正常组（C组）。分别采用配对t检验比较A组和B组治疗前后的FA值、表观扩散系数（ADC）及轴向本征值[λ=λ1]、径向本征值[λ=(λ2+λ3)/2]。采用单因素方差分析（F检验）分析A组、B组和C组之间DTI的差异，并用q检验比较组间差异。治疗前后，DTI测量区域一致。A组和B组治疗前后神经纤维束的变化通过纤维束示踪成像（DTT）显示。治疗后，A组的FA值降低，ADC值和λ值升高（t=3.037、-4.183、-4.805，均P<0.05），λ值升高（t=-1.160，P>0.05）。治疗后，B组的FA值和ADC值升高，λ值降低（t=-3.344、-3.642、4.694，均P<0.05），λ值升高（t=-0.596，P>0.05）。治疗后，三组间FA值、λ值、ADC值和λ值比较差异有统计学意义（F=71.958、70.432、75.902、22.521，均P<0.01）。FA值、λ值的变化是急性颈髓损伤脊髓功能预后最敏感的两个指标。FA值降低且λ值持续升高提示脊髓功能预后不良。DTT能直观显示神经纤维束的细微变化。
