脑梗死继发皮质脊髓束Wallerian变性的DTI动态研究

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英文篇名：DTI dynamic research of Wallerian degeneration in corticospinal tracts after cerebral ischemic infarction 作者：陈明 ; 陈洪 ; 杨国庆 ; 彭一檬 英文作者：CHEN Ming;CHEN Hong;YANG Guo-Qing;Department of Radiology,Suining Central Hospital; 关键词：扩散张量成像 ; 皮质脊髓束 ; Wallerian变性 ; 各向异性分数 英文关键词：Diffusion tensor imaging;;Corticospinal tract;;Wallerian degeneration;;Fractional anisotropy 中文刊名：FSXS 英文刊名：Radiologic Practice 机构：遂宁市中心医院放射影像科; 出版日期：2018-08-20 出版单位：放射学实践 年：2018 期：v.33 语种：中文; 页：FSXS201808021 页数：4 CN：08 ISSN：42-1208/R 分类号：72-75

摘要

目的:探讨磁共振扩散张量成像(DTI)监测脑梗死后皮质脊髓束Wallerian变性的可行性。方法:45例符合纳入标准的脑梗死患者分别于发病10天内及发病后第30和90d时进行3次全脑常规MRI和DTI数据采集,利用Fiber Track工具测量双侧大脑脚底的ADC和FA值,并计算相对ADC值(rADC)和相对FA值(rFA)。结果:MR DTI显示脑梗死发病(5.3±2.6)d后患侧大脑脚底的FA值降低,发病后首次及第30和90d时梗死侧大脑脚底FA值较对侧分别降低9.90%、23.7%和20.7%,差异均具有统计学意义(P<0.05)。梗死侧大脑脚底ADC值随时间延长而轻度升高,但与对侧比较差异均无统计学意义(P>0.05)。结论:DTI定量参数(ADC和FA)可以反映皮质脊髓束Wallerian变性的动态病理变化。DTI在脑梗死发病后5天左右即可检测出皮质脊髓束Wallerian变性,是监测脑白质微观结构早期改变的敏感方法。
        Objective:To explore the feasibility of MR diffusion tensor imaging(DTI)for monitoring Wallerian degeneration of corticospinal tracts after cerebral ischemic infarction.Methods:All forty-five patients met the inclusion criteria with cerebral infarction underwent repeatedly head MRI scanning and whole brain DTI data acquisition at time of within 10 days,and 30 and 90 days after infarction onset.DTI quantitative parameters including ADC and FA values were measured at the base of cerebral peduncle(BCP).Results:MR DTI examination showed the FA values of BCP at affected side began to decrease several days after infarction onset,the averaged time was 5 days.Compared with the unaffected side,the FA values of BCP at affected side in the first scan and 30 and 90 days after cerebral infarction decreased 9.90%,23.7% and 20.7% respectively,there were significantly statistical difference(P<0.05);the ADC values of BCP on affected side showed gradually increase at the three time points,but no significantly statistical difference existed(all P>0.05).Conclusion:DTI quantitative parameters(ADC and FA)can reflect the dynamic pathological changes of Wallerian degeneration in corticospinal tract.MR DTI could detect Wallerian degeneration of corticospinal tract as early as 5 days averaged after infarction onset,it is a sensitive method for monitoring microstructure change of cerebral white matter.

引文

[1]Song SK,Sun SW,Ju WK,et al.Diffusion tensor imaging detects and differentiates axon and myelin degeneration in mouse optic nerve after retinal ischemia[J].Neuroimage,2003,20(3):1714-1722.
    [2]Yu CS,Qin W,Li KC,et al.A longitudinal diffusion tensor imaging study on Wallerian degeneration of corticospinal tract after motor pathway stroke[J].Neuroimage,2009,47(2):451-458.
    [3]张敏,秦文,于春水,等.扩散张量成像各向异性指标对猫脑皮质脊髓束早期Wallerian变性的纵向研究[J].临床放射学杂志,2011,30(2):266-269.
    [4]van Meer MP,Otte WM,van der Marel K,et al.Extent of bilateral neuronal network reorganization and functional recovery in relation to stroke severity[J].J Neurosci,2012,32(13):4495-4507.
    [5]Kobayashi S,Hasegawa S,Maki T,et al.Retrograde degeneration of the corticospinal tract associated with potine infarction[J].J Neurol Sci,2005,236(1-2):91-93.
    [6]Qin W,Zhang M,Piao Y,et al.Wallerian degeneration in central nervous system:dynamic associations between diffusion indices and their underlying pathology[J/OL].PLoS One,2012,7(7):e41441.DOI:10.1371/journal.pone.0041441.Epub 2012Jul 19.
    [7]Concha L,Gross DW,Wheatley BM,et al.Diffusion tensor imaging of time-dependent axonal and myelin degradation after corpus callosotomy in epilepsy patients[J].Neuroimage,2006,32(3):1090-1099.
    [8]Uchino A,Sawada A,Takase Y,et al.Transient detection of early Wallerian degeneration on diffusion-weighted MRI after an acute cerebrovascular accident[J].Neuroradiology,2004,46(3):183-188.
    [9]Ahn YH,Ahn SH,Kim H,et al.Can stroke patients walk after complete lateral corticospinal tract injury of affected hemisphere[J].Neuroreport,2006,17(10):987-990.
    [10]ones KC,Hawkins C,Armstrong D,et al.Association between radiographic Wallerian degeneration and neuropathological changes post childhood stroke[J].Dev Med Child Neurol,2013,55(2):173-177.