磁共振弥散张量成像在脑小血管病变的应用初步研究
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南京市卫生局十二.五规划重大项目;南京市科技局面上项目(2012sc3150079)


A preliminary study of diffusion tensor imaging in cerebral small vessel disease
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    摘要:

    目的:探讨磁共振弥散张量成像(diffusion tensor imaging,DTI)技术对于脑小血管病变(cerebral small vessel disease,SVD)的影像评估的价值。方法:对于43例SVD患者进行磁共振常规序列和DTI序列检查,测量病灶及健侧-双侧内囊后肢和双侧大脑脚的平均弥散系数(average diffusion coefficient,DCavg)和纤维束各向异性系数(fractional anisotropy,FA)值,进行统计学分析,并利用DTT技术获得每位患者的皮质脊髓束(cortical spinal tracts,CST)图像。结果:在43例患者51个SVD病灶中,CST表现为纤维束走行自然-形态完整(41/51),纤维束受压-推移(9/51)和纤维束截然中断(1/51)3类情况。比较患侧与健侧的DCavg值和FA值,均具有统计学差异(P < 0.05),并且二者呈负相关(P < 0.05);比较慢性腔隙性梗死灶与慢性缺血灶的FA值,有统计学差异(P < 0.05)。结论:SVD病灶的DCavg值和FA值具有一定的变化规律,DTT图像对于了解SVD对CST的影响具有重要的临床参考价值。

    Abstract:

    Objective:To explore the value of diffusion tensor imaging(DTI)in radiologically evaluating cerebral small vessel disease(SVD). Methods:Forty-three cases of SVD were imaged with conventional MRI and DTI. Fifty-one lesions in 43 cases were recruited in our study. Average diffusion coefficient(DCavg)and fractional anisotropy(FA)were measured symmetrically and statistically analyzed,which were at level of the lesion and the posterior limb of internal capsule and the cerebral peduncle of the affected and contra-lateral sides. The structure images of cortical spinal tracts(CST)were obtained by diffusion tensor tractography(DTT). Results: There presented three conditions of CST on DTT:CST was showed to run naturally and have a complete structure form in 41/51 lesions,and to be pressured and shifted in 9/51 ones and interrupted in 1 lesion. Both DCavg and FA values of the affected side were different significantly from those of the contra-side(P < 0.05),and the DCavg value is negatively associated with FA value(P < 0.05). The FA values between chronic lacunar infarction and chronic ischemic focus were significantly differentiated(P < 0.05). Conclusion:DCavg and FA values of lesions in SVD changed regularly,and DTT could have a great contribution to estimate the extent of damage to CST in SVD.

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张慧丽,张颖冬,殷信道,王 未.磁共振弥散张量成像在脑小血管病变的应用初步研究[J].南京医科大学学报(自然科学版),2013,(11):1604-1607

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  • 收稿日期:2013-05-23
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  • 在线发布日期: 2013-11-25
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