创伤性脑损伤后脑白质损伤与认知功能障碍的相关性研究

被引：20

作者：

朱永山

张玉龙

程海云

李晓光

熊坤林

机构：

[1] 重庆,第三军医大学大坪医院野战外科研究所放射科

来源：

中华创伤杂志 | 2016年 / 01期

关键词：

颅脑损伤; 弥散张量成像; 认知功能;

D O I：

暂无

中图分类号：

R749.12 [];

学科分类号：

摘要：

目的利用磁共振张量成像(DTI)分析创伤性颅脑损伤(TBI)后脑白质各个参数值的变化与认知功能障碍有无相关性。方法选取2012年10月—2013年9月收治的TBI患者17例, 按照格拉斯哥昏迷评分(GCS)分为≥ 13分组(轻度组, 10例)和≤12分组(中重度组, 7例)。另选取17例健康志愿者作为对照组。均行磁共振张量成像(DTI)检查, 并使用Neuro 3D软件测量胼胝体膝部、胼胝体压部、内囊后肢、内囊前肢及大脑脚的各向异性分数(FA)及表观扩散系数(ADC)值, 比较各组FA及ADC值之间的差异。每例患者按照简易精神状态检查(MMSE)标准进行检查评分, 比较分析研究组FA及ADC值与MMSE有无相关性。结果与对照组比较, 中重度组胼胝体膝部及压部FA值明显降低, 胼胝体膝部及压部、内囊后肢及大脑脚ADC值升高(P<0.05或0.01)。轻度组各兴趣区域FA及ADC值差异无统计学意义(P>0.05)。MMSE与胼胝体膝部及压部的FA呈正相关(r分别为0.636, 0.601), 与胼胝体膝部及压部ADC值呈负相关(r分别为0.552、0.660), FA降低越明显和ADC值升高越明显, MMSE值降低越明显。结论 DTI可以发现CT及常规MRI无法显示的脑白质病变, 有助于评估TBI患者认知功能损害程度, 为治疗及预后提供客观依据。

引用

共 14 条

[1]

Mathematical Difficulties and White Matter Abnormalities in Subacute Pediatric Mild Traumatic Brain Injury.[J] Van Beek Leen;Ghesquière Pol;Lagae Lieven;De Smedt Bert Journal of neurotrauma 2015,

[2]

Microstructural brain injury in post-concussion syndrome after minor head injury.[J] Smits Marion;Houston Gavin C;Dippel Diederik W J;Wielopolski Piotr A;Vernooij Meike W;Koudstaal Peter J;Hunink M G Myriam;van der Lugt Aad Neuroradiology 2011,

[3]

Utility of diffusion tensor imaging in the acute stage of mild to moderate traumatic brain injury for detecting white matter lesions and predicting long-term cognitive function in adults.[J] Matsushita Makoto;Hosoda Kohkichi;Naitoh Yasuo;Yamashita Haruo;Kohmura Eiji Journal of neurosurgery 2011,

[4]

Diffusion tensor imaging and white matter lesions at the subacute stage in mild traumatic brain injury with persistent neurobehavioral impairment.[J] Messé Arnaud;Caplain Sophie;Paradot Gaëlle;Garrigue Delphine;Mineo Jean-François;Soto Ares Gustavo;Ducreux Denis;Vignaud Frédéric;Rozec Gaëlle;Desal Hubert;Pélégrini-Issac Mélanie;Montreuil Michèle;Benali Habib;Lehéricy Stéphane Human brain mapping 2011,

[5]

Detection of blast-related traumatic brain injury in U.S. military personnel.[J] Mac Donald Christine L;Johnson Ann M;Cooper Dana;Nelson Elliot C;Werner Nicole J;Shimony Joshua S;Snyder Abraham Z;Raichle Marcus E;Witherow John R;Fang Raymond;Flaherty Stephen F;Brody David L The New England journal of medicine 2011,

[6]

A diffusion tensor imaging study on the white matter skeleton in individuals with sports-related concussion.[J] Cubon Valerie A;Putukian Margot;Boyer Cynthia;Dettwiler Annegret Journal of neurotrauma 2011,

[7]

White matter damage and cognitive impairment after traumatic brain injury.[J] Kinnunen Kirsi Maria;Greenwood Richard;Powell Jane Hilary;Leech Robert;Hawkins Peter Charlie;Bonnelle Valerie;Patel Maneesh Chandrakant;Counsell Serena Jane;Sharp David James Brain : a journal of neurology 2011,

[8]

Novel diffusion tensor imaging methodology to detect and quantify injured regions and affected brain pathways in traumatic brain injury[J] Manbir Singh;Jeongwon Jeong;Darryl Hwang;Witaya Sungkarat;Peter Gruen Magnetic Resonance Imaging 2010,

[9]

Voxel-Based Analysis of Diffusion Tensor Imaging in Mild Traumatic Brain Injury in Adolescents [J].

Chu, Z. ;

Wilde, E. A. ;

Hunter, J. V. ;

McCauley, S. R. ;

Bigler, E. D. ;

Troyanskaya, M. ;

Yallampalli, R. ;

Chia, J. M. ;

Levin, H. S. .

AMERICAN JOURNAL OF NEURORADIOLOGY, 2010, 31 (02) :340-346

[10]

Clinical utility of diffusion tensor imaging for evaluating patients with diffuse axonal injury and cognitive disorders in the chronic stage.[J] Sugiyama Ken;Kondo Takeo;Oouchida Yutaka;Suzukamo Yoshimi;Higano Shuichi;Endo Minoru;Watanabe Hiroshi;Shindo Keiichiro;Izumi Shin-Ichi Journal of neurotrauma 2009,

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