Prediction of Functional Outcome in Acute Cerebral Hemorrhage Using Diffusion Tensor Imaging at 3T: A Prospective Study
Prediction of Functional Outcome in Acute Cerebral Hemorrhage Using Diffusion Tensor Imaging at 3T: A Prospective Study
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DOI：
10.3174/ajnr.a1639
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发表时间：
2009-09-01
影响因子：
3.5
通讯作者：
Hongo, K.
中科院分区：
文献类型：
--
作者：
Kusano, Y.;Seguchi, T.;Hongo, K.
背景和目的：早期评估锥体束是脑出血（ICH）患者决定最佳治疗或评估适当康复的先决条件。本研究的目的是在急性期使用弥散张量成像 (DTI) 评估和预测 ICH 的神经运动和功能结果。材料和方法：对 18 名偏瘫幕上 ICH 患者在发病后 2 天内使用 DTI 进行前瞻性研究。对大脑脚锥体束的分数各向异性 (FA) 进行基于感兴趣区域的分析。在第0天和第28天通过轻瘫分级（PG）评估轻瘫程度。功能结果通过改良 Rankin 量表 (mRS) 进行评估。结果：受影响侧的 FA 显着低于未受影响侧 (P = .001)，而平均扩散率保持不变 (P = .50)。受影响侧与未受影响侧的 FA (rFA) 比率与第 0 天和第 28 天的 PG 以及第 28 天的 mRS 评分显着相关（P = .002，r = -0.674；P < .001，r = -0.767；P = .002，r = -0.676）。基于 PG 的良好和不良结果的 rFA 显着不同 (P < .001)。 rFA 良好和不良结果的分界点设定为 0.85（敏感性，100%，特异性，100%）。 结论：我们得出的结论是，DTI 可以定量评估运动缺陷，并可以预测 ICH 发病后 2 天内进行扫描的 ICH 患者的功能结果。
BACKGROUND AND PURPOSE: Early evaluation of the pyramidal tract is a prerequisite in patients with intracerebral hemorrhage (ICH) in order to decide the optimal treatment or to assess appropriate rehabilitation. The aim of this study was to evaluate and predict the neuromotor and functional outcome of an ICH by using diffusion tensor imaging (DTI) in the acute phase,MATERIALS AND METHODS: Eighteen patients with a hemiparetic supratentorial ICH were prospectively studied with DTI within 2 days after onset. A region-of-interest-based analysis was performed for the fractional anisotropy (FA) of the pyramidal tract in the cerebral peduncles. The degree of paresis was assessed at day 0 and day 28 by paresis grading (PG). The functional outcome was evaluated by the modified Rankin Scale (mRS).RESULTS: The FA in the affected side was significantly lower compared with that of the unaffected side (P = .001) with the mean diffusivity remaining unchanged (P = .50). The ratio of the FA (rFA) in the affected side to the unaffected side was significantly correlated with the PG at day 0 and 28 and the mRS score at day 28 (P = .002, r = -0.674; P < .001, r = -0.767; and P = .002, r = -0.676). The rFA for the good and poor outcomes based on the PG was significantly different (P < .001). The cutoff point of the rFA for the good and poor outcomes was set at 0.85 (sensitivity, 100%, specificity, 100%).CONCLUSIONS: We conclude that DTI can evaluate the motor deficit quantitatively and may predict the functional outcome in patients with an ICH who were scanned within 2 days after the ICH onset.