| [Object] To investigate the clinical application value of diffusion tensor imaging(DTI) and diffusion tensor tractography(DTT) in cerebral infarction.[Materials and Methods] 30 patients of cerebral infarction with different disease periods were imaged with conventional skull MRI, diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI),measuring the value of fractional anisotropy(FA) both in lesions and the corresponding regions of? ? contralateral hemisphere, in addition 25 patients were performed by DTT to reconstruct bilateral white matter fiber tracts in three-dimensional. On the day being admitted to hospital and leaving hospital the patients were scored by National Institutes of Health Stroke Scale (NIHSS), respectively marked as NIHSS1 and NIHSS2. Analysis software SPSS 13.0 was performed to complete statistical process.[Results]1. Among the 30 patients with cerebral infarction,the mean value of FA in lesions was 0.300±0.105, which in the contralateral corresponding regions was 0.416±0.123.The lesion was obviously lower than the contralateral. The result of statistics had significant difference (t=-8.470, p<0.01).2. Among different disease periods, the mean value of FA in lesions were respectively: acute phase 0.345±0.116,subacute phase 0.312±0.087,chronic phase 0.172±0.070. The result of statistics had significant difference(F=7.095,p<0.01). Thereinto,the comparison between subacute phase and acute phase,p>0.05;the comparison between chronic phase and acute phase,p<0.01;the comparison between chronic phase and subacute phase,p<0.01。The decline percentage of FA in lesions were respectively: acute phase 13.26 ±10.29, subacute phase 26.86±17.24, chronic phase 49.43±8.03. The result of statistic had significant difference (F=10.261, p<0.01). Thereinto,the comparison between subacute phase and acute phase,p<0.05;the comparison between chronic phase and acute phase,p<0.01;the comparison between chronic phase and subacute phase,p<0.01。3. There was no relationship between the decline percentage of FA in lesions and NIHSS scores (compared with NIHSS1:r=0.009,p>0.05;compared with NIHSS2:r=0.015,p>0.05)。4. 25 patients’DTT imaging had showed that there were different damage of white matter fiber tracts in the area of lesions, which divided into three levels: level 1 (white matter fiber tracts completed), 3 cases, 12%; level 2 (white matter fiber tracts compressed, shifted and/or partial interrupted), 16 cases, 64%; level 3 (white matter fiber tracts mostly or completely interruptted), 6 cases, 24%.5. Among different levels of white matter fiber tracts,the NIHSS1 scores were respectively:level 1 (2.33±0.577),level 2 (6.31±2.750),level 3 (13.67±8.383),and the result of statistic had significant difference(F=7.812,p<0.01). Thereinto,the comparison between level 2 and level 1,p<0.01;the comparison between level 3 and level 1,p>0.05;the comparison between level 3 and level 2,p>0.05。The NIHSS2 scores were respectively:level 1 (0.67±0.577),level 2 (2.56±1.861),level 3 (9.83±5.269), and the result of statistic had significant difference(F=15.537,p<0.01). Thereinto,the comparison between level 2 and level 1,p<0.05;the comparison between level 3 and level 1,p<0.05;the comparison between level 3 and level 2,p<0.05.6.The level of white matter fiber tracts had significant positive correlation with NIHSS scores(compared with NIHSS1: r=0.648,p<0.01;compared with NIHSS2: r=0.725,p<0.01).[Conclusions]1. After cerebral infarction occurred for 24 hours, the mean value of FA in lesions was lower than the contralateral, so the change of FA value could help the diagnosis of cerebral infarction.2. With the extension of cerebral infarction’s timing, the decline range of FA value became more and more obvious.This change rule of FA value could help judge disease periods.3.There was no relationship between the decline percentage of FA in lesions and NIHSS scores,so FA value could not help judge illness and estimate prognosis.4. DTT technology not only realized the possibility to observe white matter fiber tracts intuitively and stereoscopically on living body,but also helped judge illness and estimate prognosis. |
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