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利用扩散张量成像评估心肌梗死后早期锥体束华勒氏变性与神经功能恢复之间的相关性。

An assessment of the correlation between early postinfarction pyramidal tract Wallerian degeneration and nerve function recovery using diffusion tensor imaging.

作者信息

Guo A H, Hao F L, Liu L F, Wang B J, Jiang X F

机构信息

Department of Neurology, Xianyang Hospital of Yan'an University, Xianyang, China.

Department of Medical Imaging, Xianyang Hospital of Yan'an University, Xianyang, China

出版信息

Genet Mol Res. 2017 Jan 23;16(1):gmr-16-01-gmr.16019035. doi: 10.4238/gmr16019035.

Abstract

This study aimed to evaluate the clinical significance of diffusion tensor imaging (DTI) in the early diagnosis of pyramidal tract Wallerian degeneration (WD) and assessment of neurological recovery following cerebral infarction. This study included 23 patients with acute cerebral infarction and 10 healthy adult controls. All participants underwent both magnetic resonance imaging (MRI) and DTI scans. DTI images were analyzed using the Functional MRI of the Brain Software Library to determine the regions of interest (ROI) and obtain the mean diffusivity (MD) and fractional anisotropy (FA) value for each ROI. The correlation between FA or MD and postinfarction functional recovery of the nervous system was further analyzed to assess the feasibility of using a DTI scan in the evaluation of functional recovery of the nervous system in patients with cerebral infarction. DTI may be useful in detecting signals of early postinfarction pyramidal tract WD and is useful for the evaluation of postinfarction neurological recovery. Cerebral lesions were detected using MRI in all patients. It was found that in some patients, the FA value of the ipsilateral pyramidal tract on DTI was decreased as early as day 3 after the onset of infarction and in all patients by day 7. Subsequent correlation studies showed that the FA value of the ipsilateral pyramidal tract on day 13 was negatively correlated with the National Institutes of Health Stroke Scale score, but positively correlated with the Barthel Index, motricity index, and modified Rankin Scale scores.

摘要

本研究旨在评估扩散张量成像(DTI)在锥体束华勒氏变性(WD)早期诊断及脑梗死神经功能恢复评估中的临床意义。本研究纳入了23例急性脑梗死患者和10名健康成人对照。所有参与者均接受了磁共振成像(MRI)和DTI扫描。使用脑功能磁共振成像软件库分析DTI图像,以确定感兴趣区域(ROI),并获取每个ROI的平均扩散率(MD)和分数各向异性(FA)值。进一步分析FA或MD与梗死后神经系统功能恢复之间的相关性,以评估使用DTI扫描评估脑梗死患者神经系统功能恢复的可行性。DTI可能有助于检测梗死后早期锥体束WD的信号,并有助于评估梗死后神经功能恢复情况。所有患者均通过MRI检测到脑部病变。结果发现,在一些患者中,DTI上患侧锥体束的FA值早在梗死发作后第3天就开始下降,到第7天时所有患者均出现下降。随后的相关性研究表明,第13天时患侧锥体束的FA值与美国国立卫生研究院卒中量表评分呈负相关,但与巴氏指数、运动指数和改良Rankin量表评分呈正相关。

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