Zhang Qinghua, Zhang Yundu, Shi Qiang, Zhao Lei, Yue Yun, Yan Chengxin
Department of Medical Imaging, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000, Shandong, China.
Department of Hyperbaric Oxygen, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000, Shandong, China.
Neurol Sci. 2023 Nov;44(11):3949-3956. doi: 10.1007/s10072-023-06908-4. Epub 2023 Jun 19.
To study the value of 3.0T magnetic resonance imaging with diffusion tensor imaging (DTI) and 3D-arterial spin labeling (ASL) perfusion imaging in the diagnosis of the crossed cerebellar diaschisis (CCD) after the unilateral supratentorial subacute cerebral hemorrhage.
Fifty-eight patients with the unilateral supratentorial subacute cerebral hemorrhage who underwent diffusion tensor imaging (DTI), 3D-arterial spin labeling (ASL), and conventional magnetic resonance imaging (MRI) scanning were enrolled. Cerebral blood flow (CBF) values of the perihematomal edema (PHE) and bilateral cerebellar hemisphere were measured on ASL mapping, and the fractional anisotropy (FA) and mean diffusivity (MD) values of the bilateral cortical, pontine, and middle cerebellar peduncle (MCP) were measured on DTI mapping.
In the CCD(+) group, FA values of the cerebral cortex and pontine ipsilateral to the lesion were statistically reduced compared to the contralateral side (P < 0.05), and the FA and MD values of the middle cerebellar peduncle (MCP) contralateral to the lesion were statistically reduced compared to the ipsilateral side (P < 0.05). Positive correlation was detected between the CBF values of the perihematomal edema (PHE) and the CBF values of cerebellar hemispheres (r = 0.642, P < 0.05), whereas the CBF values of PHE had a significantly high positive correlation with the FA in the contralateral MCP (r = 0.854, P < 0.05). CBF values in the contralateral cerebellar hemisphere correlated with FA (r = 0.466, P < 0.05) and MD values (r = 0.718, P < 0.05) in the contralateral MCP.
Hemodynamic alterations of PHE and cortical-ponts-cerebellum (CPC) fibrous pathway damage are associated with the development of CCD; DTI technique can assess the degree of CPC fiber pathway injury at an early stage.
探讨3.0T磁共振成像（MRI）联合扩散张量成像（DTI）及三维动脉自旋标记（ASL）灌注成像在单侧幕上亚急性脑出血后交叉性小脑神经机能联系不能（CCD）诊断中的价值。
纳入58例单侧幕上亚急性脑出血患者，均行扩散张量成像（DTI）、三维动脉自旋标记（ASL）及常规磁共振成像（MRI）扫描。在ASL图上测量血肿周围水肿（PHE）及双侧小脑半球的脑血流量（CBF）值，在DTI图上测量双侧皮质、脑桥及小脑中脚（MCP）的各向异性分数（FA）及平均扩散率（MD）值。
在CCD（+）组中，病变同侧大脑皮质和脑桥的FA值与对侧相比差异有统计学意义（P<0.05），病变对侧小脑中脚（MCP）的FA和MD值与同侧相比差异有统计学意义（P<0.05）。血肿周围水肿（PHE）的CBF值与小脑半球的CBF值之间呈正相关（r=0.642，P<0.05），而PHE的CBF值与对侧MCP的FA呈显著正相关（r=0.854，P<0.05）。对侧小脑半球的CBF值与对侧MCP的FA（r=0.466，P<0.05）和MD值（r=0.718，P<0.05）相关。
PHE的血流动力学改变及皮质-脑桥-小脑（CPC）纤维通路损伤与CCD的发生有关；DTI技术可早期评估CPC纤维通路损伤程度。
