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目的:应用弥散张量成像(DTI)研究脑梗死后皮质脊髓束Wallerian变性与神经运动功能缺损的相关性。方法:对11例单侧大脑中动脉供血区脑梗死的患儿进行了DTI研究。通过放置兴趣区(ROI)的方式获得定量部分各向异性(FA)和平均弥散量(MD)。ROI放置的部位包括:脑梗死区、脑梗死同侧内囊后支前部和大脑脚,以及上述部位对侧相应区域。根据手的运动情况将运动功能缺损分为轻、中和重3级。应用Mann-Whitney U检验确定差异有无显著性;应用Spearman相关检验确定皮质脊髓束DTI改变与神经运动功能缺损之间的相关性。结果:脑梗死同侧皮质脊髓束FA较对侧明显下降(P<0.05),但MD改变与对侧无明显差异(P>0.05)。FA下降与神经运动功能缺损之间存在明显相关性(r=-0.638,P=0.035)。结论:应用FA值的变化,DTI可以检测并定量分析儿童脑梗死后皮质脊髓束Wallerian变性,并可作为预测脑梗死后运动功能缺损的工具。
AIM: To study the relationship between Wallerian degeneration and neurological deficits in corticospinal tract after cerebral infarction by diffusion tensor imaging (DTI). Methods: Eleven patients with cerebral infarction in the unilateral middle cerebral artery were studied by DTI. Quantitative partial anisotropy (FA) and mean diffusivity (MD) were obtained by placing ROIs. ROI placement sites include: cerebral infarction, cerebral infarction on the same side of the anterior posterior tubercle and cerebral peduncle, and the opposite side of the corresponding region. According to the movement of the hand movement defects will be divided into light, moderate and heavy 3. The Mann-Whitney U test was used to determine whether the difference was significant. Spearman’s correlation test was used to determine the correlation between DTI changes in corticospinal tract and motor function deficits. Results: Compared with contralateral cortex and spinal cord, cerebral infarction significantly decreased in FA group (P <0.05), but there was no significant difference in MD between the two groups (P> 0.05). There was a significant correlation between FA decline and neurological deficit (r = -0.638, P = 0.035). Conclusion: The change of FA value can detect and quantify the Wallerian degeneration of corticospinal tract after cerebral infarction in children with DTI and can be used as a tool to predict motor function deficits after cerebral infarction.