文章摘要
耿花蕾,邹忆怀.基于DTI成像研究脑梗死后单侧运动通路损伤的大脑结构改变[J].实用中西医结合临床,2022,22(16):
基于DTI成像研究脑梗死后单侧运动通路损伤的大脑结构改变
Study on the changes of brain structure of unilateral motor pathway injury after cerebral infarction based on DTI imaging
投稿时间:2022-08-12  修订日期:2022-09-27
DOI:
中文关键词: 脑梗死  磁共振  弥散张量成像  各向异性分数  基于纤维束示踪的空间分析方法
英文关键词: [Key words] Cerebral infarction  Magnetic resonance imaging  Diffusion tensor imaging  Fractional anisotropy  Tract-based spatial statistics
基金项目:国家自然科学基金项目(面上项目)
作者单位E-mail
耿花蕾 北京市隆福医院神经内科 312394841@qq.com 
邹忆怀* 北京中医药大学附属东直门医院脑病科 zouyihuai2004@163.com 
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中文摘要:
      摘要:目的:探讨单侧运动通路受损脑梗死患者大脑结构的改变。方法:选择单侧运动通路受损的脑梗死患者66例,匹配性别、年龄相当的健康受试者66例。采用3.0 T磁共振扫描仪对所有受试者行DTI序列的扫描。采用基于纤维束示踪的空间分析方法(tract-based spatial statistics, TBSS)对两组脑图像进行处理,比较脑梗死受试者组和健康受试者组在大脑结构上的不同。结果:和健康受试者相比:(1)脑梗死受试者的胼胝体FA值明显降低的脑区:胼胝体膝部、胼胝体体部;(2)双侧FA值降低的相关脑区:双侧放射状前冠、双侧上放射冠;(3)患侧FA值降低的相关脑区:皮质脊髓束、大脑脚、内囊前脚、内囊后脚、内囊豆状核后部、后放射冠、丘脑后放射冠(包括视辐射)、外囊、上纵束、额枕上束和右侧绒毡层(P<0.001)。结论:单侧运动通路损伤后大脑的结构出现双侧性变化,其中枢神经机制可能是胼胝体纤维受损;患侧除了运动相关脑白质纤维结构受损,非运动相关的脑白质纤维同样会受到影响。
英文摘要:
      [Abstract] Objective To explore the changes of brain structure in patients with cerebral infarction with unilateral motor pathway damage. Methods 66 patients with cerebral infarction with unilateral motor pathway impairment were selected, and 66 healthy subjects of the same sex and age were matched. All subjects were scanned with DTI sequence by 3.0T magnetic resonance scanner. TBSS was used to process the brain images of the two groups, and the differences in brain structure between the cerebral infarction group and the healthy group were compared. Results Based on TBSS, the FA values of all stroke hemiplegic subjects and healthy subjects were obtained by processing DTI data. The results showed that compared with healthy subjects,(1)the brain areas with significantly decreased in FA value of corpus callosum in subjects with cerebral infarction including: Genu of corpus callosum, Body of corpus callosum;(2)the bilateral brain areas with significantly decreased in FA value including: Anterior corona radiate(L), Anterior corona radiate(R), Superior corona radiate(L);(3)ipsilateral brain areas with significantly reduced FA value:Corticospinal tract(R), Cerebral peduncle(R), Anterior limb of internal capsule(R), Posterior limb of internal capsule(R), Retrolenticular part of internal capsule(R), Superior corona radiate(R), Posterior corona radiate(R), Posterior thalamic radiation(R), External capsule(R), Superior longitudinal fasciculus(R), Superior fronto-occipital fasciculus(R), and Tapetum(R). ( P < 0.001). Conclusion After unilateral motor pathway stroke, the structure of the brain changes bilaterally, that is, the damage appears in the affected side and at the same time, it will also appear in the corresponding areas of the uninjured contralateral brain. The potential mechanism of structural damage in the contralateral brain region after stroke may be the damage of unaffected corpus callosum fibers; in addition to the motor-related white matter fiber structural damage, the non-motor-related white matter fiber will also be affected in the affected side.
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