Prediction of motor function by diffusion tensor tractography in patients with basal ganglion haemorrhage.

INTRODUCTION: Haemorrhagic stroke is one of the leading causes of death and the most common cause of long-term adult disability. An accurate estimation of prognosis is very important for haemorrhagic stroke patients. Impairment of motor function caused by pyramidal tract injury is common in these patients. In this study, we performed MR diffusion tensor tractography (DTT) to predict the impairment of motor function in patients with basal ganglion haemorrhage and explore its clinical value. MATERIAL AND METHODS: Diffusion tensor tractography was performed in 33 patients with basal ganglia haemorrhage within 2 weeks after onset to visualize the course of pyramidal tracts (PTs), and patients were classified into four groups according to the fibre ratio of PTs, calculated by dividing the PT number of the affected hemisphere by that of the unaffected hemisphere, as follows: type A, the fibre ratio was less than 1/4; type B, less than 1/2; type C, more than 1/2; and type D, more than 3/4. The upper extremity motricity index (UMI) was used to evaluate the motor function at onset and 6 months after onset. Upper extremity motricity index scores were compared among the different groups and a Spearman analysis was performed to correlate the UMI scores with different integrity of pyramidal tracts. RESULTS: There were no differences in the UMI scores at onset among the 4 groups (p< 0.05). The UMI scores obtained at 6 months after onset were significantly unequal and were influenced by the DTT type (p < 0.05). There was a significant correlation between the integrity of the pyramidal tracts and the UMI scores 6 months after onset (r = 0.7312, p< 0.05). CONCLUSIONS: There was a positive correlation between the integrity grade of pyramidal tracts and the motor function, showing that the more seriously were the pyramidal tracts damaged, the worse was the motor function. The DTT findings of the pyramidal tract in acute cerebral haemorrhage may valuably predict the motor function outcome.