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卒中后10～14周发生的锥体束Wallerian变性(Wallerian Degeneration,WD)可通过MRI检测,WD区在T_2加权成像表现为高信号,其发生的范围与运动障碍显著相关。作者分析幕上出血性卒中后桥脑锥体束WD的范围与日常生活活动Barthel指数之间的关系。 全组26例中,男14例,女12例,年龄38～72岁,平均57.4岁。其中壳核出血18例,丘脑出血8例。于卒中后3个月进行MRI检查,采用1.5T成像设备,自旋回波脉冲序列T_2加权成像(TR2000～2500msec TE 80msec,层厚5～7.5mm,矩阵256×192)。为进一步确定脑干WD,沿延髓前缘和脚间池最深部之间的直线行冠状面T_2加权成像,WD区呈高信号。变性范围=桥脑WD区/受累侧
Wallerian Degeneration (WD), which occurs 10 to 14 weeks after stroke, can be detected by MRI. The W zone appears to be hyperintense in T 2 -weighted imaging and its extent is significantly associated with dyskinesia. The authors analyzed the relationship between the extent of pontine pyramidal tract WD and Barthel’s index of activities of daily living after supratentorial hemorrhagic stroke. The whole group of 26 cases, 14 males and 12 females, aged 38 to 72 years, mean 57.4 years. There were 18 cases of hemorrhage in the putamen and 8 cases of thalamic hemorrhage. Three months after stroke, MRI examination was performed using 1.5T imaging equipment and T 2 -weighted imaging of spin echo pulse sequence (TR2000 ~ 2500msec TE 80msec, layer thickness 5 ~ 7.5mm, matrix 256 × 192). To further determine the brainstem WD, along the straight line between the medullary apical margin and the deepest part of the intercostal space, T 2 -weighted imaging of the coronal plane showed a high signal in the WD area. Degeneration range = Pontine WD area / affected side