Evaluation of the value of corticospinal tract injury in patients with cerebral infarction with magnetic resonance diffusion tensor and diffusion tensor teactography imaging / 中国脑血管病杂志

ABSTRACT

Objective To evaluate the relationship between the degree of corticospinal tract (CST) injury and motor function prognosis in patients with cerebral infarction using magnetic resonance diffusion tensor imaging (DTI)and diffusion tensor teactography (DTT)imaging. Methods Sixty-eight patients with cerebral infarction were selected prospectively. They underwent conventional MRI,DWI,and DTI examinations,and the DTT technique was used to perform CST 3D reconstruction. The white matter fractional anisotropy (FA)of the infarct zones and contralateral corresponding regions was measured within 7 days and at 3 months after onset. The Fugl-Meyer scale was used to perform motor function defect score. The CST involvement degrees were divided into four grades. The patients were divided into Group 1 (96-99,roughly return to normal;n=16),Group 2 (51-95,partial recovery;n=34),and Group 3 (<50,poor recovery;n=18)according to the Fugl-Meyer scale scores after treatment. The analysis of variance,Pearson,and Spearman correlation analysis were used to analyze the relationship between FA values,CST involvement degrees and motor function recovery. Results There were significant differences in the amplitude of variation of FA within 7 d (0. 05 ± 0. 06,0. 08 ± 0. 07,and 0. 18 ± 0. 02)and at 3 months after onset (0. 11 ± 0. 02,0. 21 ± 0. 06,and 0. 39 ± 0. 03)(within 7 d F=32. 821,at 3 months F=192. 372,all P<0. 05). DTT showed that the lesion sides of CST were presented as compression,deformation,displacement,and interruption. The CST grades were negatively correlated with the neurological functional rehabilitation of the patients within 7 d after onset (r= -0. 682,P <0. 01). The CST grades were negatively correlated with the neurological functional rehabilitation of the patients at 3 months (r= -0. 728,P<0. 01). Conclusion The decreased FA values in infarct areas and the degrees of CST involvement were associated with the motor function prognosis. MR DTT can directly display the degrees of CST involvement of cerebral infarction. It can provide an important basis for early identifying the prognosis of cerebral infarction.