目的：探讨弥散张量（DTI）在脑梗死后锥体束华勒变性（WD）的应用价值。方法回顾性分析经临床确诊脑梗死累及单侧大脑半球锥体束的病变并继发WD病例42例，在常规MRI（T1WI、T2WI、FLAIR）及DTI的图像上对病灶信号特征及分布特点进行分析，并对DTI中的FA值进行统计分析并总结。结果 WD的磁共振成像（MRI）表现为等或长T1、稍长T2信号，FLAIR呈稍高信号，同时伴有患侧大脑脚、丘脑及桥脑萎缩；同时对患侧及健侧大脑脚的FA值进行配对t检验分析，患侧大脑脚FA值明显低于健侧，差异有统计学意义（P＜0．05）。结论 DTI联合常规MRI可全面检出WD病灶，DTI三维扩散张量纤维束成像技术可直观了解WD病灶区的纤维束中断现象，客观证实WD的存在，为临床提供影像学证据。%Objective To investigate the value of diffusion tensor (DTI) in the application of pyramidal tract de-generation (WD) in patients with cerebral infarction. Methods Retrospectivly analyze 42 cases by clinical diagnosis of cerebral infarction involving the unilateral cerebral hemisphere pyramidal tract lesions and secondary WD patients. By conventional MRI (T1WI, T2WI, FLAIR) and DTI image the signal characteristics of lesions and distribution char-acteristic were analyzed, and the FA value of statistical analysis was summarized. Results MRI manifestations of the WD were equal or long T1 and slightly long T2 signal and FLAIR were slightly high signal. Accompanied by suffering from cerebral foot, thalamus and pons which were atrophy. And then, the affected side and the healthy side of FA values were compared by Paired T test analysis. The affected side of FA values were significantly lower than those of contralateral, the difference has statistical significance (P<0.05). Conclusion DTI combined with conventional MRI can fully detected WD lesions, 3D-DTI Diffusion tensor fiber bundle techniques can intuitively understand the WD le-sions of fiber beam interruption, objectively confirmed WD′s existence and provide imaging evidence for clinical.
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