摘要
目的应用磁共振扩散张量成像(DTI)研究脑桥梗死后锥体束继发Wallerian变性的演变过程与神经功能恢复的关系。方法对16例脑桥梗死患者(病例组)于发病<7 d、15 d、30 d、90 d和180 d进行DTI检查。另选16例正常志愿者作为对照组。测量梗死区下方的延髓、上方的大脑脚、内囊后肢及中央前后回皮质的各向异性分数(FA)值,比较病例组各时间点梗死侧与对侧以及对照组各部位FA值的差异,计算FA比值(rFA),并进行临床神经功能评分分析。结果与对照组比较,病例组脑桥梗死灶同侧的延髓、大脑脚、内囊后肢以及中央前后回皮质FA值均有不同程度降低,这种降低的趋势在发病15 d时最为显著,180 d基本恢复正常。患者发病15d时的rFA与90d、180d时的Fugl-Meyer运动功能评分均呈正相关。结论 DTI能够早期检测脑桥梗死后锥体束纤维继发的Wallerian变性。发病早期病灶同侧锥体束FA值下降的程度可预示患者远期运动功能恢复的程度。
Objective To study the evolution of WD in pyramidal tract of patients with pontine in- farction according to their magnetic resonance DTI and its relation with the recovery of nerve function. Methods Sixteen patients with pontine infarction, who underwent magnetic resonance DTI on days 7,15,30,90 and 180 respectively after onset of the disease, served as a patient group and 16 healthy subjects served as a control group. FA values were measured at the medullary bulb under the infarction area, at the cerebral peduncle, at the posterior limb of internal capsule, and at the anterior and posterior central gyrus cortex over the infarction area,respectively. Difference in FA values measured in the infarcted side and its opposite side at different time points was com- pared with that measured in those at different sites in control group. Results The FA values measured at the medullary bulb under the infarction area, at the cerebral peduncle, at the posterior limb of internal capsule,and at the anterior and posterior central gyrus cortex over the infarction area were lower,especially on day 15 after onsetof the disease in patient group than in control group,and then returned almost to their normal value on day 180 after onset of the disease. The rFA values on day 15 after onset of the disease were positively related with the Fugl-Meyer motor function scores measured on days 90 and 180 after onset of the disease. Conclusion DTI can de- tect early secondary WD in pyramidal tract of patients with pontine infarction. Decreased FA value in the homolateral pyramidal tract of patients with early pontine infarction can predict their long term recovery of motor function.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2012年第10期1024-1027,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
北京市科技新星计划(2009B047)
北京市“十百千”项目(2009-31)
北京市卫生系统高层次卫生技术人才培养基金(2011-3-094)
关键词
脑梗死
WALLER变性
磁共振成像
弥散
brain infarction
Wallerian degeneration
diffusion magnetic resonance imaging
