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目的利用白质纤维束成像(DTT)分析皮质脊髓束(CST)损伤与脑梗死预后的关系。资料与方法对35例累及基底节、内囊、放射冠等白质区的脑梗死患者进行扩散张量成像及DTT。测量患侧与健侧CST的各向异性分数(FA)值,观察CST的移位、连续性及破坏情况;采用人体肌力测试(MMT)评分标准判断脑梗死患者肌力预后情况,分析CST损伤程度与脑梗死预后的相关性。结果梗死灶和CST的关系分为接近、部分穿行和完全穿行3种。CST接近梗死灶者,FA值轻度降低(P>0.05),临床随访无明显肌力减退;CST完全穿行梗死灶者,FA值显著低于健侧(P<0.001),预后差;CST部分穿行于梗死灶者,结果介于上述两者之间。CST损伤程度与MMT评分呈明显负相关(r=-0.917,P<0.01)。结论DTT可直观显示CST损伤情况;CST的损伤程度与脑梗死预后密切相关。
Objective To analyze the relationship between corticospinal tract injury (CST) and the prognosis of cerebral infarction by using white matter fiber bundle imaging (DTT). Materials and Methods Diffusion tensor imaging (DTT) and DTT were performed on 35 patients with cerebral infarction involving the basal ganglia, the internal capsule and the corona radiata. The anisotropy (FA) values of the affected side and contralateral CST were measured to observe the displacement, continuity and destruction of CST. The assessment of muscle strength in patients with cerebral infarction was performed by MMT score, Correlation between the degree of injury and the prognosis of cerebral infarction. Results The relationship between infarction and CST was divided into three types: partial approach, partial partial approach and full bypass. The CST was slightly lower than that of the healthy side (P <0.001), and the prognosis was poor. The CST part Walk through the infarct, the result is between the two. The degree of CST injury was negatively correlated with MMT score (r = -0.917, P <0.01). Conclusion DTT can directly show the damage of CST. The degree of CST is closely related to the prognosis of cerebral infarction.