CAJ | 학술논문

目的探讨急性脑梗死后大脑脚各向异性分数(fractional anisotropy,FA)的变化特点及其与运动诱发电位(motor evoked potential,MEP)的关系,明确大脑脚FA下限值的临床意义.方法根据对照组(n=105)的FA均数-1.64标准差确定正常大脑脚FA下限值.根据能否引出MEP将急性脑梗死患者(n=58)分为MEP阳性组和MEP阴性组,其中MEP阳性组再按患侧大脑脚FA分为＜下限值组和≥下限值组.结果正常大脑脚FA下限值为0.36.MEP阴性组和MEP阳性组患侧大脑脚FA均与正常对照组存在显著差异,MEP阴性组最低(P=0.000).MFP阳性组患侧大脑脚FA显著低于健侧(P=0.000),患侧MFP潜伏期显著长于健侧(P=0.000),患侧大脑脚FA与MEP潜伏期呈负相关(r=-0.332,P=0.042).FA＜下限值组MEP潜伏期显著长于FA≥下限值组(P=0.002),各组之间健侧大脑脚FA和MEP潜伏期均无显著差异,MEP阴性组患侧大脑脚FA＜0.36的检出率最高(50%).结论急性脑梗死患者患侧大脑脚FA变化在评价患者预后方面与MEP具有相关性、一致性和互补性.MEP阴性患者中大脑脚正常FA下限值检出率最高.当患侧大脑脚FA＜0.36,尤其是在MEP阴性时预示预后可能不良.
목적 탐토급성뇌경사후대뇌각각향이성분수(fractional anisotropy,FA)적변화특점급기여운동유발전위(motor evoked potential,MEP)적관계,명학대뇌각FA하한치적림상의의.방법 근거대조조(n=105)적FA균수-1.64표준차학정정상대뇌각FA하한치.근거능부인출MEP장급성뇌경사환자(n=58)분위MEP양성조화MEP음성조,기중MEP양성조재안환측대뇌각FA분위＜하한치조화≥하한치조.결과 정상대뇌각FA하한치위0.36.MEP음성조화MEP양성조환측대뇌각FA균여정상대조조존재현저차이,MEP음성조최저(P=0.000).MFP양성조환측대뇌각FA현저저우건측(P=0.000),환측MFP잠복기현저장우건측(P=0.000),환측대뇌각FA여MEP잠복기정부상관(r=-0.332,P=0.042).FA＜하한치조MEP잠복기현저장우FA≥하한치조(P=0.002),각조지간건측대뇌각FA화MEP잠복기균무현저차이,MEP음성조환측대뇌각FA＜0.36적검출솔최고(50%).결론 급성뇌경사환자환측대뇌각FA변화재평개환자예후방면여MEP구유상관성、일치성화호보성.MEP음성환자중대뇌각정상FA하한치검출솔최고.당환측대뇌각FA＜0.36,우기시재MEP음성시예시예후가능불량.
Objective To investigate the changing characteristics of the fractional anisotropy (FA) in cerebral peduncles and its relation with motor evoked potential (MEP) after acute cerebral infarction and to clear the clinical sigiificance of the low limit value of the FA in cerebral peduncles. Methods The low limit value of the FA in normal cerebral peduncles was determined based on mean - 1. 64 standard deviation. The patients with acute cerebral infarction (n = 58) were divided into MEP positive group and MEP negative group according to the absence and presence of MEP, in which the patients in the MEP positive group were redivided into the FA in cerebral peduncles ＜ the low limit value and≥ the low limit value groups according to the FA in cerebral peduncles on the affected sides. Results The low limit value of the FA in normal cerebral peduncles was 0. 36. There was significant difference in the FA in cerebral peduncles on the affected sides between the MEP negtive and MEP positive groups. The MEP negative group was the lowest (P=0. 000). The FA in cerebral peduncles on the affected sides in the positive group was significantly lower than that on the unaffected sides (P=0. 000), and the latency on the affected sides was longer than that on the normal sides (P=0. 000). The FA in cerebral peduncles on the affected sides was negatively correlated with the MEP latency (r=-0.332,P=0. 042). The MEP latency in the FA＜the low limit value group was significantly longer than that in the FA ≥ low limit value group (P=0. 002). There were no significant differences in the FA in cerebral peduncles on the normal sides and the MEP latency among an groups. The detection rate of the FA in cerebral peduncle＜0. 36 on the affected sides was the highest (50%). Conclusions In the evaluation of the prognosis of the patients, the changes of the FA in cerebral peduncles on the affected sides in patients with acute cerebral infarction had correlation,consistency, and complementarity with MEP.The detection rate of the low limit value of the FA in normal cerebral peduncles was the highest in the MEP negative patients. When the FA in cerebral peduncles was＜0.36 on the affected sides, particularly when MET was negative, it might predict that the prognosis was poor.