磁共振弥散张量成像对脑梗死患者疗效的评价价值

摘要

目的 探讨磁共振弥散张量成像(DTI)对脑梗死患者疗效的评价价值.方法 选取2014年6月至2015年6月期间东莞市桥头医院急诊科诊治的脑梗死患者23例为研究对象,所有患者均于入院治疗前、治疗后2周、治疗后1、3、6个月均接受颅脑磁共振(MRI)平扫及DTI检查.观察脑梗死的MRI平扫及DTI特征,分析FA值、皮质脊髓束(GST)受累情况对神经功能的评价价值.结果 脑梗死病灶于FA图为低信号,病灶大小(17.4±3.9)cm3;患者病灶FA值自入院至治疗后1个月呈下降趋势,自治疗后1个月至治疗后6个月呈升高趋势(P<0.05);自入院至治疗后6个月,患者FM评分呈升高趋势,且不同级别GST受累患者FM评分间比较,差异有统计学意义(P<0.05);治疗后,不同级别GST受累患者FM评分均显著升高,且GST受累1级患者显著优于2级、3级患者,差异均有统计学意义(P<0.05).结论 在脑梗死患者疗效的评价中,磁共振弥散张量成像可以从形态学及量化指标角度提供有价值的信息.%Objective To evaluate the value of diffusion tensor imaging in assessing the curative effect in pa-tients with cerebral infarction.Methods From June 2014 to June 2015,23 patients with cerebral infarction in Emergen-cy Department of Qiaotou Hospital of Dongguan were selected as research objects.All patients underwent magnetic reso-nance imaging(MRI)plain scan and diffusion tensor imaging(DTI)scan.MRI scan and DTI features of cerebral infarc-tion were observed,and the changes of FA value,corticospinal tracts(GST)involvement,and neurological function were analyzed.Results The lesions of cerebral infarction showed low signal in FA pseudocolor image,with lesion size of (17.4±3.9)cm3.The FA value of the lesions in the patients showed a decreasing trend from admission to one month after treatment and an increasing trend from one month after treatment to six months after treatment(P<0.05).From admis-sion to six months after treatment,FM scores were significantly increased,and there were significant differences in FM scores between the groups with different degrees of GST involvement(P<0.05).After treatment,FM scores of patients with different levels of GST involvement were significantly increased,which were significantly higher in patients with grade 1 GST involvement than patients with grade 2 and grade 3 GST involvement(P<0.05).Conclusion In the evalu-ation of curative effect in patients with cerebral infarction, DTI can provide valuable information from morphological and quantitative indexes.