摘要
目的探讨脑出血患者不同时间点磁共振扩散张量成像(DTI)参数与肢体肌力恢复的相关性。方法前瞻性搜集2015年5月至2016年5月基底节区脑出血患者76例,分别在入院时和入院后2周进行DTI扫描,重组皮质脊髓束(CST),并根据CST完整性分为1~4级,并采用简式Fugl-Meye运动功能(FMS)评分评估患者入院时和入院后2周以及末次随访(≥18个月)的肌力,分析DTI参数与肌力恢复的相关性。结果入院时不同CST分级的脑出血患者其病变侧部分各向异性分数(FA)值为1级>2级>3级>4级,差异均有统计学意义(P<0.05)。入院时和末次随访时CST 1~2级患者的FMS评分显著高于3~4级者,差异均有统计学意义(P<0.05),1级和2级之间的FMS评分差异无统计学意义(P>0.05)。入院2周时不同CST分级的脑出血患者其病变侧FA值为1级>2级>3级>4级,差异均有统计学意义(P<0.05)。入院2周和末次随访时不同CST分级患者的FMS评分为1级>2级>3级>4级,差异均有统计学意义(P<0.05)。入院时病变侧的FA值与入院时的FMS评分呈显著正相关(r=0.653,P=0.012),而与末次随访时的FMS无显著相关性(r=0.326,P=0.053)。入院2周时病变侧的FA值与入院时的FMS评分和末次随访时的FMS均呈显著正相关(r=0.598,0.523,P=0.016,0.025)。结论脑出血患者不同时间点的DTI参数与患者的肌力均有关,与入院时相比,入院后2周的DTI参数与患者的肌力恢复的关系更为密切。
Objective To investigate the correlation between DTI parameters and muscle strength in patients with in- tracranial hemorrhage （ICH） at different time points. Methods 76 patients with hypertensive cerebral hemorrhage from May 2015 to May 2016 in our hospital were collected prospectively. DTI scanning and reconstruction of the eorticospinal tract were approved at admission and 2 weeks, and the relationship between the eorticospinal tract and hematoma were clas- sified as grade 1 - 4. The Fugl-Meye motor function score was approved at admission and 2 weeks and the end of the follow- up. The correlation between DTI parameters and muscle strength recovery were analyzed. Results The FA value of ICH patients with different CST grading were grade 1 〉 grade 2 〉 grade 3 〉 grade 4 at admission, and the differences were statistically significant （ P 〈 0.05 ）. The FMS in patients of grade 1 - 2 were significantly higher than that in patients of grade 3 - 4 at admission and the end of the follow-up, and the differences were statistically significant （ P 〈 0.05 ）. there were not significant difference of FMS score between grade 2 and grade 1, grade 3 and grade 4 （ P 〉 0.05 ）. The FA value of ICH patients with different CST grading were grade 1 〉 grade 2 〉 grade 3 〉 grade 4 at 2 weeks after admission, and the differences were statistically significant （ P 〈 0.05 ）. The FMS of cerebral hemorrhage patients with different CST grad- ing were grade 1 〉 grade 2 〉 grade 3 〉 grade 4 at 2 weeks after admission and the end of the follow-up,and the differ- ences were statistically significant （ P 〈 0.05 ）. The FA value at the time of admission was significantly positively correlated with the FMS score at admission （r = 0. 653 ,P = 0.012 ）, but no significant correlation with FMS on the last follow-up （r =0. 326 ,P = 0. 053 ）. The FA value at the time of admission was significantly positively correlated with the FMS score at admission and at the last follow-up FMS （r = 0. 598 0. 523,P = 0.016,0. 025 ）. Conclusion the use of DTI during the early stages of ICH may predict muscle strength. Moreover, as compared to use of DTI at admission of ICH onset, the application of DTI at 2weeks after ICH could more accurately predict the muscle strength recovery of patients.
出处
《临床放射学杂志》
CSCD
北大核心
2017年第9期1225-1228,共4页
Journal of Clinical Radiology
关键词
脑出血
磁共振成像
扩散
皮质脊髓束
肌力
Intracranial hemorrhage
Diffusion
Magnetic resonance imaging
Corticospinal tract
Muscle strength
