CAJ | 학술논문

目的：探讨深部脑白质缺血患者磁共振弥散张量成像（ DTI）表观弥散系数（ ADC值）、各向异性值（ FA值）的变化。方法选取2011年5月-2012年5月河北医科大学第一医院通过颅脑磁共振成像（ MRI）确诊为深部脑白质缺血患者30例为缺血组，另选择同时期颅脑MRI检查正常者30例为对照组，进行DTI检查，分别测量相应脑白质区的ADC值和FA值，并分析缺血组患者影像学病变程度（轻度10例，中度12例，重度8例）与各个脑白质区域ADC值和FA值的相关性。结果轻度深部脑白质缺血患者横轴位T2WI-液体衰减反转恢复序列（ FLAIR）可见双侧脑室旁斑点状高信号影，边缘欠清晰；中度深部脑白质缺血患者可见两侧脑室旁均有散在斑片状高信号影，边缘欠清晰，右侧脑室前部分融合成片；重度深部脑白质缺血患者可见两侧脑室旁均有融合呈大片状高信号影，边缘模糊。对照组与缺血组额叶、顶叶ADC值和FA值比较，差异均有统计学意义（ P<0.05）。轻度组、中度组、重度组深部脑白质缺血患者额叶、顶叶ADC值和FA值比较，差异均有统计学意义（ P<0.05）。结论应用DTI检查深部脑白质缺血患者，可以明确病变的范围和程度，而且其病变程度与ADC值和FA值具有相关性，使定量地评价深部脑白质缺血患者早期脑白质异常成为可能。
목적：탐토심부뇌백질결혈환자자공진미산장량성상（ DTI）표관미산계수（ ADC치）、각향이성치（ FA치）적변화。방법선취2011년5월-2012년5월하북의과대학제일의원통과로뇌자공진성상（ MRI）학진위심부뇌백질결혈환자30례위결혈조，령선택동시기로뇌MRI검사정상자30례위대조조，진행DTI검사，분별측량상응뇌백질구적ADC치화FA치，병분석결혈조환자영상학병변정도（경도10례，중도12례，중도8례）여각개뇌백질구역ADC치화FA치적상관성。결과경도심부뇌백질결혈환자횡축위T2WI-액체쇠감반전회복서렬（ FLAIR）가견쌍측뇌실방반점상고신호영，변연흠청석；중도심부뇌백질결혈환자가견량측뇌실방균유산재반편상고신호영，변연흠청석，우측뇌실전부분융합성편；중도심부뇌백질결혈환자가견량측뇌실방균유융합정대편상고신호영，변연모호。대조조여결혈조액협、정협ADC치화FA치비교，차이균유통계학의의（ P<0.05）。경도조、중도조、중도조심부뇌백질결혈환자액협、정협ADC치화FA치비교，차이균유통계학의의（ P<0.05）。결론응용DTI검사심부뇌백질결혈환자，가이명학병변적범위화정도，이차기병변정도여ADC치화FA치구유상관성，사정량지평개심부뇌백질결혈환자조기뇌백질이상성위가능。
Objective To investigate the changes of apparent diffusion coefficient( ADC value)and fractional anisot-ropy(FA value)in magnetic resonance diffusion tensor imaging(DTI)of deep brain white matter ischemia patients. Methods 30 cases diagnosed with deep brain white matter ischemia by magnetic resonance imaging( MRI)from May 2011 to May 2012 in the First Hospital of Hebei Medical University were chosen as ischemic group and another 30 cases with normal craniocerebral MRI during the same period were chosen as control group. Both of them underwent DTI examination to measure ADC value and FA val-ue of corresponding white matter regions so as to analyze the level of imaging lesions in the ischemic group(mild level 10 cases, moderate level 12 cases,severe level 8 cases)and the correlations between ADC value and FA value in each white matter re-gion. Results The patients with mild deep brain white matter ischemic were found spot-like high signals with unclear margin on T2WI-FLAIR axial image;The patients with moderate level were found scattered patchy high signal shadows at the two sides of periventricular with unclear margin,which were confluent in the first part of the right ventricle;Severe deep brain white matter ischemic patients were seen the integration of large sheet of high signal intensity at the two lateral ventricles with blurred mar-gin. ADC and FA values of frontal lobe and parietal lobe in the ischemia group were statistically different from those in the control group(P<0. 05)and those were also significant between mild group,moderate group and severe group(P<0. 05). Conclu-sion Using DTI to examine the deep brain white matter ischemia can make clear the range and degree of the lesion,and the cor-relations between the lesion degree and ADC value and FA value makes quantitative evaluation of early cerebral white matter ab-normalities of deep brain white matter ischemia patients possible.