DTT在基底节区急性期脑梗死预后评估中应用.docVIP

DTT在基底节区急性期脑梗死预后评估中应用 　　【摘要】 目的：探讨扩散张量纤维束成像（DTT）在基底节区急性期脑梗死预后评估中的应用价值。方法：32例发生于基底节区的脑梗死患者行常规MRI和DTT检查，首次检查后第3～4周进行DTT复查，并于工作站进行皮质脊髓束三维重建，所有病例分别于入院时和发病后1年行徒手肌力测试，比较首次检查与复查时CST分级与肌力恢复等级间的关系。结果：首次检查皮质脊髓束等级与肌力恢复等级呈负相关（P0.05）；复查皮质脊髓束等级与肌力恢复等级呈显著负相关（P0.001）；皮质脊髓束变化趋势（减少或无变化）与肌力恢复等级呈正相关（P0.05）。结论：皮质脊髓束的损伤程度与基底节区急性期脑梗死肌力恢复水平具有相关性。 　　【关键词】 扩散张量纤维束成像； 脑梗死； 基底节区； 预后 　　The Application of DTT in Prognosis Evaluation of Acute Cerebral Infarction in Basal Ganglia/LIU Song-jiang，ZHU Ke-wen，PENG Lan.//Medical Innovation of China，2015，12（23）：030-032 　　【Abstract】 Objective：To investigate the application value of diffusion tensor tractography （DTT） in evaluating the prognosis of cerebral infarction of basal ganglia in acute phase. Method：32 patients with cerebral infarction occurred in the basal ganglia were given conventional MRI and DTT examination. DTT reexamination was conducted at the third or forth week after the first examination and 3D reconstruction of corticospinal tract was arranged on workstation. Manual muscle test （MMT） was conducted on admission and one year after onset. The relationship between CST grade and muscle strength recovery level was compared with the first test and review.Result： The CST grade of the first check was negatively correlated with the muscle recovery level（P0.05）； reexamination of CST grade and muscle recovery level was negatively correlated（P0.001）；the changes trend of CST and muscle recovery levels were positively correlated（P0.05）.Conclusion：The integrity of the corticospinal tract is closely related to the muscle recovery levels of patients with cerebral infarction of basal ganglia in acute phase. 　　【Key words】 Diffusion tensor tractography； Cerebral infarction； Basal ganglia； Prognosis 　　First-author’s address：The Affiliated Hospital of Zunyi Medical College，Zunyi 563003，China 　　doi：10.3969/j.issn.1674-4985.2015.23.011 　　脑梗死一般好发于基底节区，该区域有包含皮质脊髓束（Corticospinal tract，CST）在内的众多神经纤维束走行。因此，发生于这一区域的脑梗死极易侵犯皮质脊髓束，引起皮质脊髓束的损伤，进而导致对应肢体肌力下降、功能障碍，