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目的利用磁共振弥散张量成像(DTI)评估急性脑梗死患者的认知功能。方法分别对30例急性脑梗死患者及30名健康志愿者进行 DTI 检查,观察兴趣区(ROIs)表观扩散系数(ADC)及部分各向异性(FA)的变化,同时评定患者的认知功能及神经功能缺损评分,分析内在的相关性。结果脑梗死患者组梗死区 FA 值、ADC 值(×10~(-3)mm~2/s)明显下降,平均 FA 值、ADC 值分别为0.12±0.01、1.08±0.11,其对侧相应部位平均 FA 值、ADC 值为0.35±0.08、3.46±0.26,两者相比差异有统计学意义(P<0.05);脑梗死患者健侧 ADC、FA 值与对照组相应部位对比差异无统计学意义。脑梗死同侧内囊后肢、大脑脚、皮质脊髓束与健侧相应部位相比,平均 FA 值明显下降(P<0.05)。脑梗死患者梗死区 FA 值、ADC 值与认知功能呈正相关,与 EDSS 评分具有负相关性。结论 DTI 与急性脑梗死患者认知功能具有一定的相关性,可为脑梗死患者认知功能障碍的早期诊断及早期治疗提供一些依据。
Objective To evaluate the cognitive function of patients with acute cerebral infarction by diffusion tensor imaging (DTI). Methods Thirty patients with acute cerebral infarction and 30 healthy volunteers were examined by DTI to observe the change of apparent diffusion coefficient (ADC) and partial anisotropy (FA) of ROIs. Meanwhile, the cognitive function And neurological deficit scores, analysis of the inherent correlation. Results The FA value and ADC value (× 10 ~ (-3) mm ~ 2 / s) in infarction area of patients with cerebral infarction were significantly decreased. The average FA value and ADC value were 0.12 ± 0.01 and 1.08 ± 0.11 respectively. The contralateral side The mean FA values were 0.35 ± 0.08 and 3.46 ± 0.26, respectively. There was significant difference between the two groups (P <0.05). There was no significant difference in ADC value of FA and control group between the two groups . The mean FA value of hind limbs, cerebral peduncle, corticospinal tract and ipsilateral corresponding contralateral internal capsule of cerebral infarction was significantly decreased (P <0.05). FA value and ADC value of infarction area in patients with cerebral infarction were positively correlated with cognitive function and negatively correlated with EDSS score. Conclusion DTI has some correlation with cognitive function in patients with acute cerebral infarction, and may provide some evidences for the early diagnosis and early treatment of cognitive impairment in patients with cerebral infarction.