Quantitative microstructural deficits in chronic phase of stroke with small volume infarcts: A diffusion tensor 3-D tractographic analysis.
Quantitative microstructural deficits in chronic phase of stroke with small volume infarcts: A diffusion tensor 3-D tractographic analysis.
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DOI：
10.1016/j.mri.2015.12.036
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发表时间：
2016-06
影响因子：
2.5
通讯作者：
Novak V
中科院分区：
文献类型：
--
作者：
Dubey P;Lioutas VA;Bhadelia R;Manor B;Novak P;Selim M;Novak V
非梗死区白色物质沃勒变性在大面积的区域性梗死中有很好的记录。然而，这些异常在小体积梗死中存在的程度尚不清楚，特别是因为常规T2/FLAIR MR图像显示此类病例的变化极小。因此，我们利用基于DTI的定量3D纤维束成像定量评估小体积前循环梗死慢性期的白色物质完整性。将11例前循环小血管大血管梗死（原发性梗死体积≤10 cc）的慢性卒中患者与8例年龄匹配的对照组进行比较。这些梗死在原发梗死区有可忽略的至轻度的胶质增生和脑软化，常规MRI上无明显沃勒变性。对CST、胼胝体压部、胼胝体下段进行定量扩散张量三维纤维束成像。将基于道的迹线和各向异性分数（FA）与年龄匹配的对照进行比较。在单变量分析中，与对照组相比，慢性卒中受试者在胼胝体（GCC）、病灶同侧和病灶对侧CST中的Trace测量值显著升高（p<0.05）。在调整吸烟、高血压（HTN）和非特异性白色高信号（WMH）后，同病灶CST内的痕量显著升高（p=0.05）。病灶CST FA与步行速度显著相关，r=0.67，p=0.03。小体积梗死的卒中患者在慢性期表现出显著的定量微结构白色物质异常，否则在常规成像中检测为亚阈值。量化这些变化的能力为评估慢性期非梗死区神经轴突完整性提供了重要的标志，即使是在小梗死的情况下。
Non-infarct zone white matter wallerian degeneration is well-documented in large volume territorial infarctions. However to what extent these abnormalities exist in small volume infarction is not known, particularly since routine T2/FLAIR MR images show minimal changes in such cases. We therefore utilized DTI based quantitative 3D tractography for quantitative assessment of white matter integrity in chronic phase of small volume anterior circulation infarcts. Eleven chronic stroke subjects with small anterior circulation large vessel infarcts (≤10 cc volume of primary infarct) were compared with 8 age matched controls. These infarcts had negligible to mild gliosis and encephalomalacia in the primary infarct territory without obvious wallerian degeneration on conventional MRI. Quantitative Diffusion Tensor 3-D tractography was performed for CST, genu and splenium of corpus callosum. Tract based Trace and fractional anisotropy (FA) was compared with age matched controls. On univariate analysis, Chronic stroke subjects had significant elevation in Trace measurement in genu of corpus callosum (GCC), ipsilesional and contralesional CST, (p<0.05), compared to controls. After adjusting for smoking, hypertension (HTN) and non-specific white matter hyperintensities, (WMHs), there was significant elevation in trace within the ipsilesional CST (p=0.05). Contralesional CST FA correlated significantly with walking speed, r=0.67, p=0.03. Stroke subjects with small volume infarcts demonstrate significant quantitative microstructural white matter abnormalities in chronic phase, which are otherwise subthreshold for detection on routine imaging. Ability to quantify these changes provides an important marker for assessing non-infarct zone neuroaxonal integrity in the chronic phase even in the setting of small infarction.
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影响因子：
19.7
作者：
KUHN, MJ;MIKULIS, DJ;TAVERAS, JM
通讯作者：
TAVERAS, JM
影响因子：
2.4
作者：
Troisi, Elio;Matteis, Maria;Caltagirone, Carlo
通讯作者：
Caltagirone, Carlo
影响因子：
4.8
作者：
Schaechter, Judith D.;Fricker, Zachary P.;Perdue, Katherine L.;Helmer, Karl G.;Vangel, Mark G.;Greve, Douglas N.;Makris, Nikos
通讯作者：
Makris, Nikos
DOI：
10.1186/2040-7378-1-6
发表时间：
2009-10-24
期刊：
Experimental & translational stroke medicine
影响因子：
--
作者：
Arai K;Lo EH
通讯作者：
Lo EH
影响因子：
8.3
作者：
BROTT, T;ADAMS, HP;WALKER, M
通讯作者：
WALKER, M