中国神经精神疾病杂志
中國神經精神疾病雜誌
중국신경정신질병잡지
CHINESE JOURNAL OF NERVOUS AND MENTAL DISEASES
2010年
1期
10-13
,共4页
梁志坚%张中伟%曾进胜%王芳%凌莉%侯清华%邢世会%宋来晶%裴中
樑誌堅%張中偉%曾進勝%王芳%凌莉%侯清華%邢世會%宋來晶%裴中
량지견%장중위%증진성%왕방%릉리%후청화%형세회%송래정%배중
脑梗死%弥散张量成像%各向异性%皮质脊髓束
腦梗死%瀰散張量成像%各嚮異性%皮質脊髓束
뇌경사%미산장량성상%각향이성%피질척수속
Cerebral infarct Soncondary Degeneration Corticospinal tracts Fractional anisotropy
目的 应用磁共振弥散张量成像(diffusion tensor imaging, DTI)动态观察脑梗死后颈髓皮质脊髓束的弥散变化,及其与患者神经功能恢复之间的关系,探讨脑梗死后颈髓皮质脊髓束纤维继发性损害及其意义.方法 患者分别在的第1周,第4周以及第12周进行DTI检测,每次MRI检测之前采用NIHSS、简式Fugl-Meyer运动功能评分法(FM)和Barthel生活指数(Barthel Index, BI)评定.分别测量颈髓皮质脊髓束的部分弥散各向异性(fractional anisotropy, FA)值与平均弥散量(mean diffusivity, MD).结果 与对照组比较,患者组病灶对侧颈髓皮质脊髓束FA值在各个时间点都明显低于健康对照组第1周:(0.66±0.01,vs, 0.71±0.01, P＜0.01),第4周(0.61±0.02,vs,0.69±0.01, P＜0.01),第12周(0.53±0.02,vs,0.69±0.01, P＜0.01), MD值则无明显差异.患者病灶对侧颈髓皮质脊髓束FA值在观察期内变化的百分数与NIHSS、Fugl-Meyer运动评分变化的百分数呈负相关(P<0.05).结论 局灶性脑梗死引起的皮质脊髓束纤维的继发性损害可以延续到颈髓水平,颈髓皮质脊髓束的继发性损害可能延缓患者神经功能的恢复.
目的 應用磁共振瀰散張量成像(diffusion tensor imaging, DTI)動態觀察腦梗死後頸髓皮質脊髓束的瀰散變化,及其與患者神經功能恢複之間的關繫,探討腦梗死後頸髓皮質脊髓束纖維繼髮性損害及其意義.方法 患者分彆在的第1週,第4週以及第12週進行DTI檢測,每次MRI檢測之前採用NIHSS、簡式Fugl-Meyer運動功能評分法(FM)和Barthel生活指數(Barthel Index, BI)評定.分彆測量頸髓皮質脊髓束的部分瀰散各嚮異性(fractional anisotropy, FA)值與平均瀰散量(mean diffusivity, MD).結果 與對照組比較,患者組病竈對側頸髓皮質脊髓束FA值在各箇時間點都明顯低于健康對照組第1週:(0.66±0.01,vs, 0.71±0.01, P＜0.01),第4週(0.61±0.02,vs,0.69±0.01, P＜0.01),第12週(0.53±0.02,vs,0.69±0.01, P＜0.01), MD值則無明顯差異.患者病竈對側頸髓皮質脊髓束FA值在觀察期內變化的百分數與NIHSS、Fugl-Meyer運動評分變化的百分數呈負相關(P<0.05).結論 跼竈性腦梗死引起的皮質脊髓束纖維的繼髮性損害可以延續到頸髓水平,頸髓皮質脊髓束的繼髮性損害可能延緩患者神經功能的恢複.
목적 응용자공진미산장량성상(diffusion tensor imaging, DTI)동태관찰뇌경사후경수피질척수속적미산변화,급기여환자신경공능회복지간적관계,탐토뇌경사후경수피질척수속섬유계발성손해급기의의.방법 환자분별재적제1주,제4주이급제12주진행DTI검측,매차MRI검측지전채용NIHSS、간식Fugl-Meyer운동공능평분법(FM)화Barthel생활지수(Barthel Index, BI)평정.분별측량경수피질척수속적부분미산각향이성(fractional anisotropy, FA)치여평균미산량(mean diffusivity, MD).결과 여대조조비교,환자조병조대측경수피질척수속FA치재각개시간점도명현저우건강대조조제1주:(0.66±0.01,vs, 0.71±0.01, P＜0.01),제4주(0.61±0.02,vs,0.69±0.01, P＜0.01),제12주(0.53±0.02,vs,0.69±0.01, P＜0.01), MD치칙무명현차이.환자병조대측경수피질척수속FA치재관찰기내변화적백분수여NIHSS、Fugl-Meyer운동평분변화적백분수정부상관(P<0.05).결론 국조성뇌경사인기적피질척수속섬유적계발성손해가이연속도경수수평,경수피질척수속적계발성손해가능연완환자신경공능적회복.
Objective To investigate the secondary degeneration of corticospinal tracts in cervical spinal cord following a recently cerebral infarct with diffusion tensor imaging(DTI) and its potential impact on neurological recovery.Methods Twenty-six patients with a focal cerebral infract underwent DTI at the first week, the fourth and twelfth week after stroke onset, respectively.The NIH Stroke Scale (NIHSS), the Fugl-Meyer motor scale (FM) and the barthel index (BI) were used to evaluate the neurological function before every DTI.Twenty-six gender and age match healthy volunteers underwent DTI three times at same time points.The DTI parameters of mean diffusivity (MD) and fractional anisotropy (FA value) were measured at the cervical spinal cord and initial lesion.Results Compared to the controls, the FA values of the contralateral side corticospinal tracts in the cervical spinal cord in patients significantly decreased at every observed time point (P<0.01).In patients group, the FA values of the contralateral side corticospinal tracts in the cervical spinal cord decreased progressively from 1~(st) week to 12~(th) week (P<0.01), but MD remained unchange.The absolute value of the percent reduction of FA value of the contralateral side corticospinal tracts in the cervical spinal cord in patients associated negatively with the absolute value of the percent change of NIHSS and FM (P<0.05), but not with the absolute value of the percent change of BI(P>0.05).Conclusions Conclusions: The secondary degeneration of the corticospinal tracts resulted from cerebral infarction may extend to the cervical spinal cord.Which may last at lest three months and thus hamper the process of neurological recovery.
