《中国康复理论与实践》

《中国康复理论与实践》 ›› 2012, Vol. 18 ›› Issue (1): 73-76.

• 论文 • 上一篇    下一篇

中老年缺血性脑卒中患者康复治疗前后的弥散张量成像研究

张晓钰，桑德春   

  1. 中国康复研究中心北京博爱医院综合康复科，北京市 100068。
  • 收稿日期:2011-07-06 修回日期:2011-08-24 出版日期:2012-01-25 发布日期:2012-01-25

Diffusion Tensor Imaging in Different Age Patients with Ischemic Stroke before and after Rehabilitation Treatment

ZHANG Xiao-yu, SANG De-chun.   

  1. Department of General Rehabilitation, China Rehabilitation Research Centre, Beijing 100068, China
  • Received:2011-07-06 Revised:2011-08-24 Published:2012-01-25 Online:2012-01-25

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被引次数

22

摘要： 目的利用磁共振弥散张量成像(DTI)研究中老年脑梗死患者脑白质纤维束各向异性特征和皮质脊髓束(CST)受损与临床预后的关系。方法24 例中老年单侧急性脑梗死患者，依年龄段分为A组(45～59 岁)、B 组(60～74 岁)和C 组(75 岁以上)，每组各8 例。患者于发病3 d 内行3.0 T 常规磁共振(MRI)和DTI 检查。于入院时和发病后6 周，分别测量梗死灶和对侧相应正常脑组织的部分各向异性值(FA)，同时采用美国国立卫生院脑卒中量表(NIHSS)进行神经功能缺损评分，并运用弥散张量纤维束成像(DTT)显示通过病灶的纤维束特征，评价脑梗死区周边纤维束的情况，并与神经功能缺损程度进行比较。结果各组患者梗死侧FA值均较对侧相应正常脑组织降低(P<0.05)，康复治疗6 周后梗死侧的FA值均比入院时增加(P<0.05)。各年龄组患者CST 2 级的NISHH评分均高于CST 1 级(P<0.05)。在同组同一CST 级别的患者发病后6 周NIHSS 评分均低于入院时NIHSS 评分(P<0.05)。结论DTT 可直观显示纤维束走行及与病灶之间的关系，在缺血性脑卒中的早期即可对其损伤情况进行判定，同时也可提示患者的预后，对患者的康复治疗具有一定的指导意义。

关键词: 脑卒中, 脑梗死, 康复治疗, 弥散张量成像, 年龄相关

Abstract: Objective To explore the relationship between injury of corticospinal tract (CST), diffusion anisotropic features of white matter fibers and cerebral infarction prognosis in patients with different ages by MRI and diffusion tensor imaging (DTI). Methods 24 cases of cerebral infarction were divided into 3 groups according to age: Group A (n=8, 45～59 years old), Group B (n=8, 60～74 years old) and Group C (n=8, 75～82 years old). DTI were acquired in the patients on a 3.0 T MR imaging scanner in the first 3 days. Before and 6 weeks af-ter treatment, Fractional anistrophy (FA) value of the infarcted focus and the contralateral corresponding brain tissues were measured, and the nerve function were measured by National Institutes of Health Stroke Scale (NIHSS). Results FA values of the infarcted focus were less than the FA of contralateral corresponding brain tissues (P<0.05) and they were significantly improved 6 weeks after treatment (P<0.05).The NISHH scores of corticospinal tract (CST) 2 were higher than that of CST 1 in each group (P<0.05). The NISHH scores after admission were lower than the scores on admission in the same group and the same CST level. Conclusion DTT can show the relationship between the direction and morphology of the fiber tract and the infarct lesions, which can be used to evaluate the impairment of CST at the early stage of ischemic stroke, favoring the prognostic judgment in the rehabilitative therapy of cerebral infarction.

Key words: stroke, cerebral infarction, rehabilitation treatment, diffusion tensor imaging, age-related