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凌 晴,林丽萍,胡世红,许 佳.磁共振弥散张量成像在脑卒中后皮质脊髓束损伤与运动功能的相关性研究[J].中国康复医学杂志,2016,(2):140~144
磁共振弥散张量成像在脑卒中后皮质脊髓束损伤与运动功能的相关性研究    点此下载全文
凌 晴  林丽萍  胡世红  许 佳
复旦大学附属上海市第五人民医院康复医学科,上海,200240
基金项目:上海市闵行区卫计委课题资助项目(2013MW07)
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摘要:
      摘要 目的:应用磁共振弥散张量成像(MR-diffusion tensor imaging, DTI)探讨脑卒中后皮质脊髓束(corticospinal tract, CST)损伤与运动功能的相关性。 方法:29例脑卒中后偏瘫患者,分为脑出血组15例,脑梗死组14例,病变部位为内囊基底核区,且累及皮质脊髓束,发病后30—60d采用1.5T核磁共振仪进行弥散张量成像扫描,依次从大脑脚、内囊后肢、放射冠区、初级皮质运动区4个层面,测量病变同侧皮质脊髓束和病变对侧相应脑组织的部分各向异性值(FA),计算得出FA比值(rFA)及FA不对称性(FAasy),同时采用简化Fugl-Meyer运动功能量表(The Fugl-Meyer motor assessment, FMA)对偏瘫肢体运动功能评分。 结果:病灶侧4个层面CST的FA值均较对侧相应脑组织降低。脑出血组:大脑脚、内囊后肢、放射冠区3个层面的FA值、rFA和FAasy均与FMA评分之间存在相关性,且放射冠层面有显著相关性;而初级皮质运动区层面的FA值、rFA和FAasy与FMA评分之间无明显相关性。脑梗死组:大脑脚、内囊后肢、放射冠区、初级皮质运动区4个层面的FA值、rFA和FAasy均与FMA评分之间存在相关性,且放射冠层面有显著相关性。 结论:DTI可用于评估脑卒中后皮质脊髓束损伤及运动功能障碍,以放射冠层面皮质脊髓束的DTI参数最有意义。
关键词:脑卒中  运动功能  弥散张量成像  皮质脊髓束
The relation between injury of corticospinal tract and motor function of stroke patients using MR-diffusion tensor imaging    Download Fulltext
Department of Rehabilitation Medicine, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, 200240
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Abstract:
      Abstract Objective: To explore the relationship between injury of corticospinal tract (CST) and limb motor function by MR-diffusion tensor imaging (DTI) in stroke patients. Method: Twenty-nine stroke patients were divided into two groups: hemorrhage group (n=15) and infarction group (n=14). MR-DTI were acquired in the patients at 30—60 days after stroke onset. The fractional anisotropy (FA), rFA and FAasymmetry(FAasy) of 4 sections of CST (cerebral peduncle, posterior limb of internal capsule (PLIC), corona radiate and primary motor cortex) were evaluated. The Fugl-Meyer motor assessment (FMA) was applied to evaluate motor function. The relation between imaging parameters in each group and the motor function scores were assessed. Result: The FA values within 4 sections of CST in the ipsilesional side were significantly lower than those in the contralateral side. The motor function showed statistically significant relationship with FA, rFA and FAasy of cerebral peduncle, PLIC, corona radiate in two groups, and corona radiate section of CST showed strong correlation. But in primary motor cortex section of CST, no correlation was found between the motor function FMA score and FA, rFA and FAasy in hemorrhage group. In infarction group,FA,rFA and FAasy of 4 sections of CST(cerebral peduncle, PLIC, corona radiate and primary motor cortex) showed correlation with FMA score, and corona radiate section showed significant relation. Conclusion: DTI can be used to evaluate motor function and corticospinal tract injury after stroke, especially in the coronaradiate section.
Keywords:stroke  motor function  diffusion tensor imaging  corticospinal tract
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