论文部分内容阅读
目的探讨磁共振弥散张量成像(DTI)与弥散张量纤维束示踪技术(DTT)对早期弥漫性轴索损伤(DAI)的诊断应用价值。方法对22例DAI早期(伤后10天内)患者(DAI组)及12例正常志愿者(对照组)分别行常规MR扫描及弥散张量成像扫描。在FA图上分别测量DAI组及对照组双侧半球白质感兴趣区(胼胝体压部、胼胝体膝部、内囊前肢、内囊后肢)部分各向异性(FA)值,将两组感兴趣区(ROI)平均FA值的差异进行比较,并对DAI组FA值与临床GCS评分进行相关性分析。运用弥散张量纤维束成像显示通过病灶的纤维束特征。结果病变组与对照组比较,DAI早期FA值(胼胝体压部0.647±0.069、胼胝体膝部0.615±0.043、内囊前肢0.541±0.065、内囊后肢0.639±0.035)较对照组(胼胝体压部0.748±0.045、胼胝体膝部0.729±0.058、内囊前肢0.622±0.038、内囊后肢0.667±0.027)FA值显著降低(P<0.001)。胼胝体压部FA值的变化与GCS评分呈正相关(r=0.736,P=0.001)。DTT较好显示感兴趣区白质纤维束形态,更直观显示脑白质损伤程度。结论 DTI联合DTT是DAI患者检查的敏感方法,FA值评估是DAI程度的重要依据,DDT可观察神经纤维束受损范围。
Objective To investigate the value of magnetic resonance diffusion tensor imaging (DTI) and diffusion tensor fiber tractography (DTT) in the diagnosis of early diffuse axonal injury (DAI). Methods Twenty-two patients with early DAI (within 10 days after injury) (DAI group) and 12 normal volunteers (control group) underwent routine MR and diffusion tensor imaging. The FA values of bilateral white matter regions of interest (corpus callosum, knee of the corpus callosum, forelimb of the internal capsule, hind limb of the internal capsule) in the DAI group and the control group were measured respectively on the FA maps. The two groups of regions of interest (ROI) between the average FA value were compared, and DAI group FA value and clinical GCS score correlation analysis. DIFFUSED TENSOR FIBER BUNDLE IMAGING The fiber bundle features that pass through the lesion are shown. Results Compared with the control group, the values of FA (0.647 ± 0.069 in the corpus callosum, 0.615 ± 0.043 in the corpus callosum, 0.541 ± 0.065 in the forelimb of the corpus callosum and 0.639 ± 0.035 in the hindlimb of the internal capsule) in the DAI group were significantly higher than those in the control group (0.748 ± 0.045, 0.729 ± 0.058 in the corpus callosum, 0.622 ± 0.038 in the forelimb of the internal capsule and 0.667 ± 0.027 in the hindlimb of the internal capsule) (P <0.001). The change of FA value of corpus callosum was positively correlated with GCS score (r = 0.736, P = 0.001). DTT better shows the white matter in the region of interest, and more intuitive display of white matter damage. Conclusions DTI combined with DTT is a sensitive method for the examination of DAI patients. Evaluation of FA value is an important basis for the degree of DAI. DDT can observe the extent of nerve fiber bundle damage.