Department of Radiology, Hebei Provincial Gucheng County People's Hospital, Gucheng County, Hebei Province, China.
Department of Radiology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Medicine (Baltimore). 2024 Oct 25;103(43):e40300. doi: 10.1097/MD.0000000000040300.
To retrospectively explore the role of magnetic resonance imaging (MRI) diffusion tensor imaging (DTI) in analyzing the corticospinal tract injury in acute cerebral anterior circulation infarction in the basal ganglia region and the correlation between DTI parameters and neurological function scores, patients with acute cerebral infarction and stroke had undergone plain MRI and DTI sequence scanning were enrolled. Diffusion tensor tractography was used to perform 3-dimensional reconstruction of bilateral corticospinal tracts (CST). The image data were processed to obtain fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values, and the correlation between the DTI parameters and neurological function scores of National Institutes of Health Stroke Scale (NIHSS) was evaluated. A total of thirty-two patients with acute ischemic cerebral infarction were retrospectively enrolled, including 19 males and 13 females with a mean age 63.22 ± 7.78 years. The CST score was 0 in 2 (6.25%) patients, 1 in 9 (28.13%), 2 in 9 (28.13%), 3 in 7 (21.88%), and 4 in 5 (15.63%). The FA value significantly (P = .01) decreased (0.52 ± 0.03 vs 0.62 ± 0.04) on the ischemic side compared with that on the normal side. A significant (P < .05) difference was detected in the number of nerve fibers (223.3 ± 110.0 vs 246.7 ± 104.4) rather than in the ADC values (0.86 ± 0.06 vs 0.84 ± 0.06) between the ischemic and healthy sides. The FA and ADC values were not significantly (P > .05) different according to the CST scores 0, 1, 2, 3, or 4 between the ischemic and healthy sides. There was a significant (P < .05) negative correlation between the FA value on the infarcted side and the NIHSS score. In conclusion, with the DTI technology, varying degrees of damage to the corticospinal tract at the infarcted side can be detected and important clinical information can be provided for the diagnosis and prognosis of acute cerebral infarction by evaluating the degree of corticospinal tract injury.
回顾性分析磁共振弥散张量成像（DTI）在分析基底节区急性大脑前循环梗死皮质脊髓束损伤中的作用及 DTI 参数与神经功能评分的相关性。
选取急性脑梗死患者，均行常规 MRI 和 DTI 序列扫描，采用弥散张量纤维束示踪技术对双侧皮质脊髓束（CST）进行三维重建，对图像数据进行处理，得到各向异性分数（FA）和表观弥散系数（ADC）值，评估 DTI 参数与国立卫生研究院卒中量表（NIHSS）神经功能评分的相关性。
共纳入 32 例急性缺血性脑梗死患者，男 19 例，女 13 例，年龄 63.22±7.78 岁。CST 评分 0 分 2 例（6.25%），1 分 9 例（28.13%），2 分 9 例（28.13%），3 分 7 例（21.88%），4 分 5 例（15.63%）。患侧 CST 的 FA 值显著低于健侧（0.52±0.03 比 0.62±0.04，P=0.01）。患侧与健侧神经纤维数量（223.3±110.0 比 246.7±104.4）差异有统计学意义（P<0.05），而 ADC 值差异无统计学意义（0.86±0.06 比 0.84±0.06）。FA 值和 ADC 值在患侧 CST 评分 0、1、2、3 和 4 时与健侧差异均无统计学意义（P>0.05）。患侧 CST 的 FA 值与 NIHSS 评分呈显著负相关（P<0.05）。
DTI 技术可检测到病变侧皮质脊髓束的不同程度损伤，通过评估皮质脊髓束损伤程度，可为急性脑梗死的诊断和预后提供重要的临床信息。
