CAJ | 학술논문

目的分析脑梗死患者磁共振弥散张量成像(DTI)和纤维束成像(DTT)的特点，探讨DTI、DTT在对不同时期脑梗死患者诊断的价值。方法分别对58例不同时期脑梗死患者和25名健康志愿者行MRI检查，包括T1WI、T2WI成像、FLAIR及DTI成像，重建部分各向异性(FA)图，对梗死区、健侧相应部位及正常对照组相应部位进行FA值、表观弥散系数(ADC)值测量。结果①DTI显示的梗死灶范围较常规MRI成像更加准确、清晰。②超急性、急性、亚急性、慢性期脑梗死组病变侧梗死中心的FA值与ADC 值分别为(0.24±0.02、0.3 1±0.11)、(0.20±0.02、0.32±0.12)、(0.18±0.02、0.34±0.11)、(0.16±0.02、0.37±0.13)；低于各期正常侧映像位置的( 0.40±0.03、0.70±0.21)、(0.37±0.03、0.71±0.21)、(0.39±0.03、0.72±0.22)、(0.40±0.03、0.72±0.23)，其差异有统计学意义(P＜0.05)；脑梗死患者健侧FA和ADC值与正常对照组对应部位比较，差异无统计学意义（P＞0.05）。③脑梗死后脑组织的FA值和ADC值随梗死时间呈一定规律性变化，在超急性期患侧FA值较对侧无一致性变化，可轻度升高或轻度降低，随后（急性期、亚急性期、慢性期）降低；患侧ADC值随梗死时间延长呈明显降低、逐渐恢复正常、继而又升高的规律。结论DTI、DTT检查有助于明确脑梗死是否累及白质纤维束，FA值与ADC值联合能更精确地对脑梗死进行临床分期和定位。
목적 분석뇌경사환자자공진미산장량성상(DTI)화섬유속성상(DTT)적특점，탐토DTI、DTT재대불동시기뇌경사환자진단적개치。방법분별대58례불동시기뇌경사환자화25명건강지원자행MRI검사，포괄T1WI、T2WI성상、FLAIR급DTI성상，중건부분각향이성(FA)도，대경사구、건측상응부위급정상대조조상응부위진행FA치、표관미산계수(ADC)치측량。결과①DTI현시적경사조범위교상규MRI성상경가준학、청석。②초급성、급성、아급성、만성기뇌경사조병변측경사중심적FA치여ADC 치분별위(0.24±0.02、0.3 1±0.11)、(0.20±0.02、0.32±0.12)、(0.18±0.02、0.34±0.11)、(0.16±0.02、0.37±0.13)；저우각기정상측영상위치적( 0.40±0.03、0.70±0.21)、(0.37±0.03、0.71±0.21)、(0.39±0.03、0.72±0.22)、(0.40±0.03、0.72±0.23)，기차이유통계학의의(P＜0.05)；뇌경사환자건측FA화ADC치여정상대조조대응부위비교，차이무통계학의의（P＞0.05）。③뇌경사후뇌조직적FA치화ADC치수경사시간정일정규률성변화，재초급성기환측FA치교대측무일치성변화，가경도승고혹경도강저，수후（급성기、아급성기、만성기）강저；환측ADC치수경사시간연장정명현강저、축점회복정상、계이우승고적규률。결론DTI、DTT검사유조우명학뇌경사시부루급백질섬유속，FA치여ADC치연합능경정학지대뇌경사진행림상분기화정위。
Objective To analyze the characteristics of magnetic resonance diffusion tensor imaging(DTI)and diffusion tensor tractography (DTIT) in patients with cerebral infarction, and explore the diagnosis values and prognosis of diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) in patients with cerebral infarction in different stages. Methods 58 patients with cerebral infarction in different stages and 25 healthy volunteers were examined by magnetic resonance imaging (MRI), including conventional T1 and T2 weighted imaging, DWI and DTI. Fractional anisotropy (FA) images were reconstructed. The values of FA and apparent diffusion coefficient (ADC) were measured in the infarcted regions, corresponding contralateral normal regions and corresponding normal regions in normal control group. Results ①DWI and DTI showed size of infarction focus was more accurate and clearer than that of conventional MRI; ②The FA and ADC values of the infarcted regions during superacute stage, acute stage, subacute stage and chronic stage were (0.24±0.02, 0.31 ±0.11), (0.20±0.02, 0.32±0.12), (0.18±0.02, 0.34±0.11) and (0.16±0.02, 0.37±0.13), respectively, lower than those in the contralateral corresponding regions which were (0.40±0.03, 0.70±0.21), (0.37±0.03, 0.71±0.21), (0.39±0.03, 0.72±0.22) and (0.40:±0.03, 0.72±0.23), respectively. The differences were statistically significant (P＜0.05). The FA and ADC values had no significant differences between the uninjured sides in patients with cerebral infarction and the corresponding regions in the normal control group (P＞0.05); ③The FA and ADC values in brain tissues changed regularly with the time of infarction after cerebral infarction. The FA values in the affected sides had no consistent changes as compared with the contralateral sides in the superacute stage. They increased or decreased slightly, then (during acute stage, subacute stage and chronic stage) decreased irreversibly. The ADC values in the affected sides changed with time regularly, they decreased significantly, gradually returned to normal, and then increased again. Conclusion DTI and DTT examination contribute to the diagnosis of cerebral infarction. The combination of the FA and ADC values may more accurately conduct clinical staging and evaluate the time of the occurrence of cerebral infarction.