Long-term Functional Outcome Correlating With Diffusion Tensor Imaging Of Subacute Stroke Patients

Objective:It is unclear how wallerian degeneriation(WD) of pyramidal tract(PT) in the subacute phase of a stroke patient correlates with the long-term functional outcome. The aim of this study was to quantify and predict the long-term neuromotor outcome of patients with stroke by diffusion tensor imaging(DTI) in the subacute phase.methods:Thirty stroke patients,male(18)、femal(12),age(60.2±9.1) years,who were first attacked,hemiplegy and had no any other neurosistem disease,and can be permitted to be excuted MRI scanned about1month after the onset were enrolled.The neurologic impairment and the degree of paresis was assed at time1month and6months by National Institute of Health Stroke Scale(NIHSS) and Paresis Grading(PG) respectively. In addition,the activity of daily life、equilibriun function and the overall functional prognosis was evaluated by functional independent measures(FIM)、Brunel Balance Assessment (BBA^modified Ranking Scale(mRS) respectively.The MRI scanning was implemented by1.5Tesla superconductor magnetic Resonace scanner(Signa GE Healthcare,HDX),at time1month and3months in following up. The fractional anisotropy(FA) of the CST in the cerebral peduncles was analysised by a region of interest(ROI) method. SPSS17.0is used to analysis the correlation between FA value and respective chronic assessment. Adopted Reciever Operation Curve to analysis and compare the distinction effect to predict the long-term outcome between the two different Fractional Anisotropy of ratio(rFA) at the two different time points.Result:The FA in the affected side at the two points is significantly lower compar eded with that of the unaffected side(p<0.001, p<0.001).The3month Fractional Anis otropy of ratio is evidently lower compareded with that of1month(p<0.001).Compar eded that of1month,the rFA of3months was more visibly correlated with NIHSS、 PG、FIM、BBA、mRS at the end of following(r=-0.613, p<0.001; r=-0.640, p<0.001; r=0.678, p<0.001; r=0.475, p=0.008; r=-0.637, p<0.001).The area under recei ver operating characteristic curve(ROC) of rFA at the point of3months for the good and poor outcomes based on the PG was greater than the area under ROC of rFA at time point of1month. The cutoff point of the rFA at3months for the good and p oor outcomes was set at0.630(sensitity,68.4%,specifity,81.8%).Conclusion:We can conclude that DTI can evaluate the motor deficit quatitively and may predict the functional outcome in patient with superatenterior stroke who were in subacute phase after the stroke onset.DTI at3months compared to that at1month can effectively predict the long-term outcome and activity of daily living in patients with supertenterior stroke.