Comparative Study Of DTI With DTT And NIHSS Scoring System In Acute Ischemic Cerebral Infarction's Prognosis Evaluation

Objective:To explore the Prognosis evaluation of MR diffusion tensor imaging (DTI) and NIHSS scoring system in acute ischemic cerebral infarction patients and provide clinical references for the disease. Methods:All the patients were collected from department of Neurology of the Second Affiliated Hospital of Xinjiang Medical University from January 2010 to January 2011, totally 34 patients, including 19 males and 15 females, aged 35-73 years, mean 58±2.4 years. All patients in the acute phase (onset<72h) did 1.5T conventional MRI examination DTI and DTT, measure the FA and ADC values of infarct and corresponding part of the contralateral normal brain tissue; Three patterns of CST involvement were identified according to the relation of the corticospinal tract (CST) and infarct:close, partly involved and completely involved.the completely involved is paralysis roup partly involved is partial recovery group, the close is fully recovery group, and they are regarded as theoretical predicted value.The 34 patients were divided into 3 groups according to the NIHSS evaluation, NIHSS score> 16 points, patients are completely paralyzed group, between 6 to 16, patients will be defined as part of the recovery group, less than 6 points were defined as fully recovery group. After therapy, the patients were evalued by MMT test, the results were compared with above theoretical value, then we observe its compliance rate. Result:The NIHSS score of 34 patients from 2 to30 and which was (4.13±1.356) in the 6 fully recoverys and (11.47±3.067)in the 13 partial recoverys and (23.09±4.482) in the16 paralysis. the difference was significant (p<0.01); Compared with corresponding part of the contralateral normal brain tissue, the FA and ADC values of white matter in infarct region of acute ischemic cerebral infarction patients decreased and the decretion ratio of FA was positively correlated with the onset time, it had statistical significance (P<0.05); compare the coincidence of actual value in two system, the DTI with DTT was more better than NIHSS, the difference had statistical significance (P<0.05). Conclusion:(1) According to NIHSS and the relationship between CST and infarct region, we divided the patients into different groups, they were good methods to evaluate the pathogenetic and prognosis of the diseases in patients with acute ischemic cerebral infarction. (2) with the NIHSS score increased, higher risk of limb paralysis would appear; Compared with corresponding part of the contralateral normal brain tissue, the FA and ADC values of white matter in infarct region of acute ischemic cerebral infarction patients decresed and the decretion ratio of FA was positively correlated with the onset time. (3) From coincidence results of the two systems,we can see that the coincidence of DTI with DTT was more.