脑卒中后椎体束华勒变性的功能磁共振研究.doc

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1、脑卒中后椎体束华勒变性的功能磁共振研究毕玉堂-娄明武2•申云霞^(1深圳市龙岗区慢性病防治院广东深圳518172;2深圳龙岗中心医院•广东深圳518116;3广州中医药大学广东广州510006)摘要：目的应用扩散张量与磁共振波谱技术対急性脑卒中患者进行分析•探讨其反映患者病情变化的价值方法取一侧脑卒中患者26例健康志愿者30例在常规扫描后再逬行DTI-MRS扫描采用NIHSS和BI评分评价患者功能•并定期复查分析患者梗死病灶、大脑脚ADC值、FA值及MRS的代谢产物数值变化结果1)病灶FA值低于正常值与NIHSS呈正相尖•与BI呈负相尖脑干FA值减小提示

2、神经纤维出现华勒变性;2)病灶NAA下降低于正常侧P<001;病灶侧CrCho较正常侧改变不明显P>005;大脑脚NAA1个月后降低结论对脑卒中患者迸行DTI与MRS扫描能较早反映患者病情严重程度还能判断预后并指导临床康复治疗笑键词：功能磁共振；脑卒中；华勒变性；扩散张量成像；磁共振波谱成像中图分类号：R743:R445文献标志码：AApplicationoffMRIforDetectionofWallerianDegenerationinCorticospinalTractafterStrokeBlYu4ang'LOUMingW-SHENYun^ia2

3、3(1TheChronicDiseasePreventionandTreatmentInstitutionofLonggangDistrictinShenzhenCity-Shenzhen518172China;2LonggangGenterHospitalinShenzhenCity-Shenzhen518116China;3GuangzhouChineseMedicalUniversityGuangzhou510006China)Abstract:ObjectiveToinvestigatethevalueofDTI(DiffusionTensorI

4、maging)andMRS(MagneticResonanceSpectroscopy)inacutecerebralinfarctionMethod26patientswithstrokewereselectedasthesubjectsand30healthyvolunteersweretakenasthecontrolAftertheroutineseanOTIandMRSwereperformedonthemondtheywerereexaminedatregularintervalsNTHSS(NationalInstituteofHealth

5、StrokeScale)andBTwereusedtoevaluatetheirfunctionsChangesinvaluesofADCFAandmetabolitesattheinfarctionfocusofcerebralpedunclewereanalyzedandcomparedResults1)ThevalueofFAatinfarctionfocuswaslowerthanthatthenormalvalueandshowedanegativecorrelationwithBlbutapositivecorrelationwithNIHS

6、SThevalueofFAinthebraintemdeclined-indicatingWalleriandegenerationofthenervousfibers2)NAAvalueatinfarctionfocuswasdecreasedsignificantlycomparedwiththatofthecontralateralarea(P<001)CrandChovaluesinthefocusdidnotchangesignificantlycomparedwiththoseinthecontralateralareaNAAvalueint

7、hecerebralpeduncledeceasesedafteronemonth.ConclusionTheapplicationofDTIandMRSforthepatientwithstrokecouldreflecttherecoveryofthepatientandpredictedtheprognosis-whichshouldbeinstructivetotheclinicalrehabilitation.Keywords:functionalmagneticresonanceimaging(fMRI);stroke;Walleriande

8、gene「ation;diffusiontensorimaging(DTI);m