Role of diffusion tensor imaging in evaluating corticspinal tract damage outcome for patients with basal ganglia hemorrhage
CHEN Qing-hua1, XU Qing-qing2, YIN Xin-dao1
1.Department of Medical Imaging, Nanjing Hospital Affiliated of Nanjing Medical University, Nanjing 210006, China;2.Department of Medical Imaging, Huaian First Hospital of Nanjing Medical University, Huaian Jiangsu 210006, China
Abstract：Objective: To evaluate the role of diffusion tensor imaging(DTI) in evaluating the corticspinal tract(CST) damage and predicting neurological motor function outcome for patients with basal ganglia hemorrhage. Methods: Thirty-six patients with intracerebral hemorrhage in basal ganglia underwent 3.0T MR scanning with routine sequences and DTI sequence in the period of 8 to 15 days and 4 to 6 months after onset. A region-of-interest-based analysis was performed for mean FA values within the cerebral peduncle. According to the extent of the CST damage on DTT maps, group A(CST undestroyed), group B(CST was interrupted around the hematoma) and group C(CST did not reach the hematoma) were classified. The ratios of FA values in the affected and unaffected hemisphere(rFA) within the cerebral peduncle were compared between the two groups and two examinations(the first time and follow-up examinations). The correlations of rFA with modified Rankin Scale (mRS) scores and the motor component of the functional independence measure(FIMm) at 4~6 months after onset were analysed. Results: In the period of 8 to 15 days, the motor function of type C was worse than that of type A or B(P<0.05), and motor function of type A was better than that of type C(P<0.05). In the period of 4 to 6 months, of 16 type A, only 2 changed to type B; of 12 type B, 11 changed to type A and 1 changed to type C; of 8 type C, 2 changed to type A, 1 changed to type B and 5 remained the same. There was statistically significant difference(P<0.05) in FA values between the affected and unaffected cerebral peduncle at two DTTs. There was statistically significant difference in FA values of the affected between the two examinations(P<0.05) and unaffected cerebral peduncle between the two examinations(P<0.05). The rFA values from the cerebral peduncle were correlated with mRS scores(P<0.05), but not correlated with FIMm scores at two DTTs. At the first DTT, a weak correlation was revealed between rFA and FIMm scores in group A(P＜0.05) and a strong correlation between rFA and FIMm scores in group B(P＜0.05). At the second DTT, strong correlation was revealed between rFA and mRS scores in group A(P＜0.05). Conclusions: For basal ganglia hemorrhage, rFA values from the cerebral peduncle could predict long-term neurological motor function outcome and CST damage.
2015, Vol. 26 
