The role of diffusion tensor imaging in motor outcome prediction in subcortical cerebral infarction in the acute period / 中华神经科杂志

ABSTRACT

Objective To observe the patients with subcortical cerebral infarction in the acute period, disabled in the motor function, and explore the extent of impact of several predictive factors to the recovery of motor function, including diffusion tensor imaging (DTF) displaying the involving extent of pyramidal tract, in order to find the most reliable and closely predictors. Methods 82 patients with acute cerebral infarction and disability (mRS score ≥ 3 points) were followed up on the 90 d after the symptom onset, respectively. Combining the baseline clinical characteristics, the laboratory and imaging auxiliary examination and treatment methods, choosing gender, age, hypertension, diabetes, hypercholesterolemia,atrial fibrillation or angina history, smoking history, alcohol history, the initial disability level,homocysteine, C-reactive protein, treatment modalities, the volume of infarction and the involving extent of pyramidal tract as observed indicators. According to mRS result, the outcome of the patients were divided into disabled groups ( mRS 3-5) and non-disabled group ( mRS 0-2). Results Using chi-square test to make univariate analysis, results showed that age (χ2 = 47.492, P ＜ 0. 01 ), diabetes ( χ2 = 5. 126, P =0. 024), hypercholesterolemia(χ2 =6. 242 ,P = 0. 012), the initial degree of disability (χ2 =45. 359, P ＜0. 01 ) and the involving extent of pyramidal tract (χ2 = 51. 467, P ＜ 0. 01 ) could effect patients gaining recovering. Using multivariate Logistic regression analysis to make a multivariate regression analysis, results suggest that age ( OR = 0. 068, P = 0. 042), the involving extent of pyramidal tract ( OR = 0. 026, P = 0. 002 )are independent predictors of recovery of motor function in patients, diabetes mellitus, hypercholesterolemia,initial disability level have no significant correlation. Conclusion The involving extent of pyramidal tract reflected by DTT is the best predictor of recovery in patients with subcortical cerebral infarction in the acute period.