摘要
目的探讨磁共振弥散张量成像(DTI)在急性脑卒中患者运动神经损伤康复疗效预测中的价值。方法采用美国国立卫生研究院卒中量表(NIHSS)、日常生活能力(ADL)量表、缺血性脑卒中/短暂性脑缺血发作(TIA)风险评估(ESSEN)量表、缺血性脑卒中/TIA风险评估(ABCD2)评分量表挑选我院2009年3月～2011年12月中重度急性脑卒中住院患者17例,发病1周内完成头颅磁共振血管显影(MRI)、弥散加权成像(DWI)、磁共振血管造影(MRA)和DTI检查、简化Fugl-Meyer运动功能(F-M量表)评分,发病2周后开始行物理康复治疗,发病10～12周复查头颅MRI和DTI、简化F-M量表评分。结果急性脑卒中患者发病1周内病灶区平均各向异性分数(FA)值(0.39±0.10)较健侧相应部位(0.57±0.11)降低,差异有统计学意义(P<0.01);康复治疗前、后DTI中病灶部位不同兴趣区(ROI)对应的FA差值变化和F-M量表评分差值变化均有统计学意义(P<0.01);入院1周内DTI中ROI对应的健患侧FA差值同康复治疗前后F-M量表评分差值变化呈线性正相关关系(rs=0.497,P<0.05)。结论 DTI中FA值改变与运动神经损伤程度、康复疗效存在关联性,急性期DTI对肢体功能障碍康复治疗疗效预测有一定的价值。
Objective To explore the predictability value of motor nerves injury and rehabilitation outcomes according to the diffusion tensor imaging （ DTI ） in patients with acute stroke. Methods Using NIHSS ,ADL,ESSEN ,ABCD2 , 17 inpatients with moderate or serious acute stroke were selected from March, 2009 to December,2011. All of the 17 patients were underwent MRI, DWI, MRS and DTI of head and the Fugl-Meyer motor assessment （ F-M ） within 1 week after attack. Physical treatment of rehabilitation was started after two weeks of acute stroke onsetting. Head examinations of MRI, DTI and the F-M assessment were performed again at the 10 - 12 weeks. Results The average fractional anisotropy （FA） scores was decreased significantly （ P 〈 0.01 ） in focus areas （0.39± 0.10 ） of acute stroke patients, compared with opposite health corresponding areas （0.57 ± 0.11 ）. FA scores and F-M value in different region of interest （ROI） differed significantly （P 〈 0.01） before and after rehabilitation treatment. The differences of FA scores in ROI between focus areas and opposite corresponding areas within 1 week were positive correlated with F-M value before and after rehabilitation （ r8 = 0. 497, P 〈 0.05 ）. Conclusions The motor nerves injuryand rehabilitation outcomes are correlated with FA values in DTI. There are some predictability valuesto the rehabilitation outcomes with the help of DTI in acute stroke before rehabilitation undergoing.
出处
《中华脑血管病杂志（电子版）》
2012年第4期16-19,共4页
Chinese Journal of Cerebrovascular Diseases(Electronic Edition)
