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目的分析脑梗死患者磁共振弥散张量成像(DTI)的特点,探讨DTI在不同时期对脑梗死患者诊断的价值。方法分别对40例不同时期脑梗死患者和40名健康志愿者行MR I检查,包括T1、T2加权成像、弥散加权成像及DTI,重建部分各向异性(FA)图,对梗死区、健侧相应部位及正常对照组相应部位进行FA值、表观弥散系数(ADC)值测量。结果①DTI显示的梗死灶范围较常规MR I成像更加准确、清晰。②脑梗死组患者梗死区及梗死同侧内囊后肢、大脑脚、皮质脊髓束的FA值分别为0.12±0.01、0.29±0.03、0.36±0.12及0.35±0.04,低于对侧相应部位的0.35±0.08、0.50±0.13、0.53±0.14、0.56±0.07,差异均具有显著性(P<0.05);脑梗死患者健侧ADC、FA值与正常对照组相应部位对比,差异无显著性(P>0.05)。③脑梗死后脑组织FA值、ADC值随梗死时间呈一定规律性变化,在超早期患侧FA值较对侧无一致性变化,可轻度升高或轻度降低,随后(急性期、亚急性期、慢性期)降低;患侧ADC值随梗死时间延长呈明显减低、逐渐恢复正常、继而又升高的规律。结论DTI检查有助于明确脑梗死是否累及白质纤维束,ADC值与FA值联合能更精确对脑梗死进行临床分期和定位。
Objective To analyze the characteristics of magnetic resonance diffusion tensor imaging (DTI) in patients with cerebral infarction and investigate the value of DTI in the diagnosis of patients with cerebral infarction at different stages. Methods Forty patients with cerebral infarction and 40 healthy volunteers underwent MRI examination including T1, T2 weighted imaging, diffusion weighted imaging and DTI, reconstruction of partial anisotropy (FA) The corresponding parts and normal control group corresponding parts FA value, apparent diffusion coefficient (ADC) value measurement. Results ① The range of infarct size showed by DTI was more accurate and clear than that of conventional MRI. ② The FA values of hindlimb, cerebral peduncle and corticospinal tract in ipsilateral infarcts and cerebral infarction group were 0.12 ± 0.01,0.29 ± 0.03,0.36 ± 0.12 and 0.35 ± 0.04, respectively, which were lower than 0.35 ± 0.08,0.50 ± 0.13,0.53 ± 0.14,0.56 ± 0.07, respectively (all P <0.05). There was no significant difference between the contralateral ADC and FA values in the contralateral cerebral infarction and the normal control group (P> 0.05). The FA value and ADC value of cerebral tissue after cerebral infarction showed a regular change with infarct time. There was no consistent change in FA value at the early stage of ipsilateral compared with the contralateral side, which could be slightly or mildly decreased Acute phase, chronic phase) decreased; ipsilateral ADC value decreased significantly with the extension of infarct time, gradually returned to normal, and then increased again. Conclusion DTI examination can help to determine whether cerebral infarction involves white matter fiber bundles. The combination of ADC value and FA value can be more accurate for clinical staging and location of cerebral infarction.