本文選題：腦梗死 + 擴(kuò)散張量成像��； 參考：《中國腦血管病雜志》2015年07期

【摘要】：目的應(yīng)用磁共振擴(kuò)散張量成像(DTI)及擴(kuò)散張量纖維束成像(DTT)評(píng)價(jià)腦梗死患者皮質(zhì)脊髓束(CST)損傷程度及與運(yùn)動(dòng)功能預(yù)后的關(guān)系。方法前瞻性納入腦梗死患者68例,行常規(guī)MRI、DWI、DTI檢查,并應(yīng)用DTT技術(shù)進(jìn)行CST三維重組,于發(fā)病7 d內(nèi)和3個(gè)月時(shí)測(cè)量腦梗死區(qū)及健側(cè)相應(yīng)區(qū)域白質(zhì)各向異性分?jǐn)?shù)(FA),采用Fugl-Meyer量表進(jìn)行運(yùn)動(dòng)功能評(píng)分,將CST受累程度分為4級(jí)。根據(jù)治療后Fugl-Meyer評(píng)分情況將患者分為1組(96~99分,大致恢復(fù)正常,16例)、2組(51~95分,部分恢復(fù),34例)、3組(≤50分,恢復(fù)差,18例),采用方差分析、Pearson和Spearman相關(guān)分析,分析腦梗死區(qū)FA值及CST受累程度與運(yùn)動(dòng)功能恢復(fù)的關(guān)系。結(jié)果發(fā)病7 d內(nèi)和3個(gè)月時(shí)3組FA的變化幅度[(0.05±0.06、0.08±0.07、0.18±0.02)、(0.11±0.02、0.21±0.06、0.39±0.03)]差異有統(tǒng)計(jì)學(xué)意義(7 d內(nèi)F=32.821,3個(gè)月時(shí)F=192.372,均P0.05)。DTT顯示CST病變側(cè)表現(xiàn)為受壓、變形、移位和中斷。發(fā)病7 d內(nèi)CST等級(jí)與患者肢體肌力呈負(fù)相關(guān)(r=-0.682,P0.01),3個(gè)月復(fù)查CST等級(jí)與患者肢體肌力呈負(fù)相關(guān)(r=-0.728,P0.01)。結(jié)論腦梗死患者梗死區(qū)FA值降低及CST受累程度均與運(yùn)動(dòng)功能預(yù)后有關(guān)。MR DTT能直觀顯示CST受累程度,可為早期判斷腦梗死預(yù)后提供重要依據(jù)。
[Abstract]:Objective to evaluate the relationship between the damage degree of the corticospinal tract (CST) and the prognosis of motor function in patients with cerebral infarction by magnetic resonance diffusion tensor imaging (DTI) and diffusion tensor fiber beam imaging (DTT). Methods 68 patients with cerebral infarction were prospectively included, routine MRI, DWI, DTI examination were performed, and DTT technique was used to reconstruct the CST, within 7 d and 3 cases. The white matter anisotropy fraction (FA) in the cerebral infarction area and the corresponding region was measured at month time. The Fugl-Meyer scale was used to score the movement function, and the degree of CST involvement was divided into 4 levels. The patients were divided into 1 groups according to the Fugl-Meyer score after treatment (96~99, roughly normal, 16 cases), and the 2 groups (51~95, partial recovery, 34 cases), and the 3 groups (< < 50 points, poor recovery). 18 cases), using variance analysis, Pearson and Spearman correlation analysis, the relationship between the FA value of cerebral infarction and the degree of CST involvement and the recovery of motor function was analyzed. Results the range of changes of FA in the 3 groups (0.05 + 0.06,0.08 + 0.07,0.18 + 0.02) and (0.11 + 0.02,0.21 + 0.06,0.39 + 0.03) in the 7 d and 3 months was statistically significant (7 d within F=32.821,3). At month F=192.372, P0.05).DTT showed that the CST lesion side showed compression, deformation, displacement and interruption. The CST grade in 7 d was negatively correlated with the patient's limb muscle strength (r=-0.682, P0.01), and the 3 month reexamination CST grade was negatively correlated with the patient's limb muscle strength (r=-0.728, P0.01). .MR DTT can directly display the degree of CST involvement and provide an important basis for early judgement of prognosis of cerebral infarction.

【作者單位】： 河南省商丘市第一人民醫(yī)院神經(jīng)內(nèi)科;
【分類號(hào)】：R743.3;R445.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 鄭莎莎;盧潔;李坤成;;擴(kuò)散張量成像在評(píng)價(jià)腦梗死預(yù)后的研究進(jìn)展[J];中華老年心腦血管病雜志;2011年10期

2 ;各類腦血管疾病診斷要點(diǎn)[J];中華神經(jīng)科雜志;1996年06期

【共引文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉劍波,史曉冬;香丹注射液對(duì)腦梗死患者血液流變學(xué)的干預(yù)作用[J];安徽中醫(yī)臨床雜志;2003年04期

2 黃俊臣,周紀(jì)平,李彥春;核桃承氣湯對(duì)腦梗死急性期輔助治療作用的觀察[J];安徽中醫(yī)臨床雜志;2003年04期

3 龐家善,李樹標(biāo),陳艷艷;自擬化痰祛瘀方治療急性腦梗死療效觀察[J];中醫(yī)藥臨床雜志;2004年01期

4 潘啟明,張松林,蘭小平;自擬偏癱方配合早期康復(fù)治療腦梗死偏癱56例臨床觀察[J];中醫(yī)藥臨床雜志;2004年02期

5 華卡;復(fù)方丹參注射液治療急性腦梗死臨床藥效分析[J];中醫(yī)藥臨床雜志;2004年04期

6 郭漢強(qiáng);醒腦凈合息風(fēng)通絡(luò)化痰湯對(duì)急性腦出血的治療作用[J];中醫(yī)藥臨床雜志;2004年05期

7 張波,鄭軍,鮑遠(yuǎn)程,蔡永亮,陳懷珍,王艷昕,王曉e，

本文編號(hào)：1830992