| Objective: Application of diffusion tensor imaging(DTI)technology assessed corticospinal tract(CST)injury situation in patients with hypertensive basal ganglia hemorrhage,and analysised the correlation of damage and prognosis of recovery,and comparative analysised of the significance of internal capsule and cerebral peduncle in prognosis prediction of patients.Methods: A total of 25 patients with intracerebral hemorrhage diagnosed in the affiliated hospital of qinghai university were collected.The patients were scanned by the skull DTI within 3 days and 3 weeks after admission to obtain the diffusion tensor tractography(DTT).The CST passing through posterior limb of the internal capsule and the lateral area of cerebral peduncle were taken as the interest area,and the FA value of the affected-side internal capsule and the affected-side cerebral peduncle was measured,and the r FA value was obtained by calculation.According to the DTT results,CST was divided into 4 levels,and the patients with CST injuries of 1 and 2 levels were divided into group A(CST undamaged group),and group B(CST failure group)at level 3 and 4.The movement function scores were evaluated in patients in the three days and three weeks after admission,and the evaluation standards used in NIHSS to measure the function of motion(Paresis Grading,PG);At 3 months after onset,the target patients were modified Rankin scale follow-up score,the last line of statistical analysis.Results: The pedunculus cerebri of affected side average FA(0.55±0.08)and the inner capsule average FA(0.34±0.09)were observed in all patients at 3 days of admission.There was no statistically significant difference(p=0.45)between the r FA value group A(0.88±0.09)and group B of cerebral peduncle,but there was statistically significant difference between the r FA value group A(0.70±0.12)and group B(0.49±0.10)of internal capsule,and the comparison between group A(2.17±0.75)and group B(5.84±1.30)was also statistically significant of PG rating.Correlation analysis found that patients with onset within 3 days of PG rating associated with internal capsule of r FA r =-0.59(P=0.002),no correlation with r FA in cerebral peduncle value r=-0.22(P=0.29).At 3 weeks,the inner capsule of affected side average r FA(0.64±0.14)was higher,PG rating(3.56±1.76)decreased obviously in all patients than in admission,and statistically significant,and found that both have obvious correlation r=-0.61(P = 0.001);The r FA value(0.65±0.14)in the pedunculus cerebri of affected side was lower than before,and the r FA value and PG score of the treatment were also significantly correlated with r=-0.80(P=0.000).All of the patients after 3 month follow-up m RS score averaged(2.32±1.31),and the hospital within 3 days of internal capsule r FA relevance for r=-0.47(P=0.017),and the hospital within 3 days of cerebral peduncle,the correlation of r FA for r=-0.20(P=0.347),and 3 weeks of internal capsule r FA relevance of r=-0.56(P=0.003),and 3 weeks of cerebral peduncle r FA relevance for r=-0.66(P = 0.000).Conclusion: In patients with acute hypertensive basal ganglia hemorrhage,the damaged condition of the side CST can be quantitatively analyzed by the r FA value of the inner capsule,showing the lower r FA value in the inner capsule region,and the higher the paralysis classification.After internal medicine treatment,the damage degree of CST in the cerebral peduncle region was worse than that of the hospital,which may be related to the degeneration of HWI,but it was consistent with the level of paralysis.Hospital internal capsule r FA during 3 days,3 weeks and 3 weeks of movement function in patients with cerebral peduncle from values in r FA can predict the prognosis of outcome,but the cerebral peduncle r FA for three weeks was better than that of the other two indexes. |
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