磁共振弥散张量成像对脑梗死患者疗效的评价价值
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摘要
目的探讨磁共振弥散张量成像(DTI)对脑梗死患者疗效的评价价值。方法选取2014年6月至2015年6月期间东莞市桥头医院急诊科诊治的脑梗死患者23例为研究对象,所有患者均于入院治疗前、治疗后2周、治疗后1、3、6个月均接受颅脑磁共振(MRI)平扫及DTI检查。观察脑梗死的MRI平扫及DTI特征,分析FA值、皮质脊髓束(GST)受累情况对神经功能的评价价值。结果脑梗死病灶于FA图为低信号,病灶大小(17.4±3.9)cm~3;患者病灶FA值自入院至治疗后1个月呈下降趋势,自治疗后1个月至治疗后6个月呈升高趋势(P<0.05);自入院至治疗后6个月,患者FM评分呈升高趋势,且不同级别GST受累患者FM评分间比较,差异有统计学意义(P<0.05);治疗后,不同级别GST受累患者FM评分均显著升高,且GST受累1级患者显著优于2级、3级患者,差异均有统计学意义(P<0.05)。结论在脑梗死患者疗效的评价中,磁共振弥散张量成像可以从形态学及量化指标角度提供有价值的信息。
Objective To evaluate the value of diffusion tensor imaging in assessing the curative effect in patients with cerebral infarction. Methods From June 2014 to June 2015, 23 patients with cerebral infarction in Emergency Department of Qiaotou Hospital of Dongguan were selected as research objects. All patients underwent magnetic resonance imaging(MRI) plain scan and diffusion tensor imaging(DTI) scan. MRI scan and DTI features of cerebral infarction were observed, and the changes of FA value, corticospinal tracts(GST) involvement, and neurological function were analyzed. Results The lesions of cerebral infarction showed low signal in FA pseudocolor image, with lesion size of(17.4±3.9) cm~3. The FA value of the lesions in the patients showed a decreasing trend from admission to one month after treatment and an increasing trend from one month after treatment to six months after treatment(P<0.05). From admission to six months after treatment, FM scores were significantly increased, and there were significant differences in FM scores between the groups with different degrees of GST involvement(P<0.05). After treatment, FM scores of patients with different levels of GST involvement were significantly increased, which were significantly higher in patients with grade 1 GST involvement than patients with grade 2 and grade 3 GST involvement(P<0.05). Conclusion In the evaluation of curative effect in patients with cerebral infarction, DTI can provide valuable information from morphological and quantitative indexes.
Objective To evaluate the value of diffusion tensor imaging in assessing the curative effect in patients with cerebral infarction. Methods From June 2014 to June 2015, 23 patients with cerebral infarction in Emergency Department of Qiaotou Hospital of Dongguan were selected as research objects. All patients underwent magnetic resonance imaging(MRI) plain scan and diffusion tensor imaging(DTI) scan. MRI scan and DTI features of cerebral infarction were observed, and the changes of FA value, corticospinal tracts(GST) involvement, and neurological function were analyzed. Results The lesions of cerebral infarction showed low signal in FA pseudocolor image, with lesion size of(17.4±3.9) cm~3. The FA value of the lesions in the patients showed a decreasing trend from admission to one month after treatment and an increasing trend from one month after treatment to six months after treatment(P<0.05). From admission to six months after treatment, FM scores were significantly increased, and there were significant differences in FM scores between the groups with different degrees of GST involvement(P<0.05). After treatment, FM scores of patients with different levels of GST involvement were significantly increased, which were significantly higher in patients with grade 1 GST involvement than patients with grade 2 and grade 3 GST involvement(P<0.05). Conclusion In the evaluation of curative effect in patients with cerebral infarction, DTI can provide valuable information from morphological and quantitative indexes.
引文
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[9]李春芳,胡海菁,张应和,等.弥散张量成像对脑梗死患者功能恢复的预测价值[J].中华物理医学与康复杂志,2010,32(3):195-197.
[10]徐青青,周俊山,孙军,等.急性脑梗死性皮质脊髓束受损磁共振弥散张量成像的临床初步应用[J].实用放射学杂志,2014,30(1):12-16.
[2]韩忠丽,李晓夫,高颖,等.3.0T磁共振弥散张量成像在急性脑梗死评估中的应用研究[J].中国急救医学,2012,32(4):352-354.
[3]季鹏,袁晓毅,朱瑞.磁共振弥散张量成像联合神经纤维束示踪技术在急性脑梗死中的临床应用[J].中国现代医学杂志,2013,23(29):64-68.
[4]刘树学,王本国,莫雪玲,等.磁共振弥散张量成像(DTI)在脑梗死皮质脊髓束损伤与运动功能转归相关性中的应用研究[J].中国CT和MRI杂志,2011,9(5):28-31.
[5]王苇,赵义,周龙江,等.脑梗死偏瘫患者针刺下神经作用机制的血氧水平依赖性功能磁共振成像及弥散张量成像研究[J].中华物理医学与康复杂志,2015,37(9):662-667.
[6]周宏伟,兰文婧,刘洋,等.弥散加权和弥散张量成像在脑梗死诊断中的应用[J].吉林大学学报:医学版,2009,35(4):742-745.
[7]陆强彬,朱祖福,姜岐涛,等.磁共振弥散张量成像评价脑梗死视辐射损伤的研究[J].中国康复理论与实践,2016,22(7):818-820.
[8]毕国力,包颜明,田伟,等.磁共振扩散张量成像在判断脑梗死预后中的初步研究[J].临床放射学杂志,2008,27(9):1166-1170.
[9]李春芳,胡海菁,张应和,等.弥散张量成像对脑梗死患者功能恢复的预测价值[J].中华物理医学与康复杂志,2010,32(3):195-197.
[10]徐青青,周俊山,孙军,等.急性脑梗死性皮质脊髓束受损磁共振弥散张量成像的临床初步应用[J].实用放射学杂志,2014,30(1):12-16.