Preliminary Study Of Diffusion Tensor Imaging About Meridan Of Hemorrhagic Apoplexy

Purpose:First of all, observing the damage in the meridian of stroke syndrome of Hyperactivity of liver Yang, wind heat disturbance syndrome, Phlegm heat, wind phlegm syndrome and Yinxu Fengdong syndrome of corticospinal tract through diffusion tensor imaging techniques to analyze the damage differences between each type of CST of the meridian, and compare the three groups of FA value ratio (rFA value), the score of Fugl-Meyer (F-M) and the score of NIHSS to provide objective clinical observation index for cerebral hemorrhage in meridian. Finally analysis is made about that if there is any correlation between the level of CST of 32 cases and F-M ratings, rFA value and with NIHSS score, and What’s more, the comparison between the CST levels and rFA value to explore the clinical application value of DTI evaluating the neural functions.Method:First, collecting 32 cases of hemorrhagic stroke patients aged 45 to 77 (59.13±9.60) with bleeding volume between 8～24ml (14.88±4.60). All the research objects have to have DTI check in the first onset week and be measured side and contralateral cerebral peduncle area FA value based on the region of interest (ROI). And they should have assessment of NIHSS and F-M at the onset within one week, then reconstruct their bilateral CST after DTI check. Then analyze the correlation between the CST level and F-M ratings, rFA value and NIHSS score of the 32 patients and the comparison among different level of CST and rFA value. And dividing the 32 patients into three groups according to the syndrome type:the group of Hyperactivity of liver Yang, wind heat disturbance syndrome (12cases), the group of Phlegm heat, wind phlegm syndrome (9cases), and group of Yin wind syndrome (11 cases). And then comparing the differences among each type of CST damage of meridian and making a comparison of rFA value, F-M ratings and NIHSS score of the three groups.Result:1. According to the bilateral FA value comparison of the 32 cases, it can be found that the FA value of the ipsilateral damaged area is significantly lower than the contralateral damaged area. The difference is statistically significant (P<0.05). Through the formula of ipsilatera FA/the contralateral FA, the FA value ratio (rFA) is got and there is significantly negative correlation between rFA value and NIHSS score (P<0.05), which shows the higher the rFA value is, the lower is the NIHSS score.2.There are no statistical difference (P>0.05) among the general information, DTI inspection and motor function assessment time of the patients of different CST levels. Through comparison different levels of CST with rFA value, the difference is statistically significant (P<0.05). But it can be regarded that different levels of CST and rFA values are not all the same. Further comparison is showed in CST level 1 and level 2, CST level 1 and level 3, and CST level 2 and level 3(all P<0.05), which-shows that the difference has statistically significance. The analysis of F-M in the different level of CST shows significantly negative correlation between the different levels of CST and F-M ratings (P<0.05), which shows the higher the CST levels is, the lower is the F-M ratings.3.The general information, DTI inspection and motor function assessment time of the three Hemorrhage stroke in meridian groups have no statistical difference (P>0.05), the difference is statistically significant. It can be deemed that the cases distribution of the three groups’CST levels is not the. same. Further comparison shows that difference (P<0.05) in the group of Hyperactivity of liver Yang, wind heat disturbance syndrome, Phlegm heat, wind phlegm syndrome and Yinxu Fengdong syndrome of corticospinal tract, has statistically significance. While the difference (P>0.05) between the group of Hyperactivity of liver Yang, wind heat disturbance syndrome and Phlegm heat, wind phlegm syndrome of CST levels has no statistically significance. By comparison, it can be seen that the CST levels of the group of Yin wind syndrome is obviously higher than that of the group of Hyperactivity of liver Yang, wind heat disturbance syndrome and the group of Phlegm heat, wind phlegm syndrome. Checking the rFA value, F-M ratings and NIHSS score of the three groups respectively (all P>0.5), the difference is statistically significant, as a result the rFA value distribution of three groups can be deemed is not all the same. By comparing the results multiply, it can be found that difference (are P<005) between the rFA value, F-M ratings and NIHSS score of the group of the Yin wind syndrome and the group of the Hyperactivity of liver Yang, wind heat disturbance syndrome, Phlegm heat, wind phlegm syndrome has statistically significance. What’s more, the difference (all P>005) between the rFA value,F-M ratings and NIHSS score of the group of the wind phlegm into collaterals and the group of the Wind Yang nuisance has no statistically significance. By comparison, it can be seen that the rFA value and F-M ratings of the group of Yinxu Fengdong syndrome is lower than that of the group of Hyperactivity of liver Yang, wind heat disturbance syndrome and the group of Phlegm heat, wind phlegm syndrome.Conclusion:1. There are some differences between the degree of CST damage and the FA value of the group of the Yinxu wind syndrome, the group of Hyperactivity of liver Yang, wind heat disturbance syndrome, Phlegm heat and ind phlegm syndrome. DTI and FA value can be the objective marker in the clinic observation of Yinxu wind syndrome group.2. DTI can display the degree of CST damage in hemorrhage clearly and directly, that can help guide the formulation of treatment.