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陈丹凤,燕铁斌,黎冠东,胡荣亮,梁启堂.磁共振弥散张量成像参数与脑卒中早期患者下肢运动功能恢复的相关性研究[J].中国康复医学杂志,2018,(7):812~816
磁共振弥散张量成像参数与脑卒中早期患者下肢运动功能恢复的相关性研究    点此下载全文
陈丹凤  燕铁斌  黎冠东  胡荣亮  梁启堂
广东省江门市中心医院康复医学科,广东江门,529000
基金项目:江门市科技局计划项目(2016020100540002340);广州市科技计划项目(201704020140)
DOI:
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摘要:
      摘要 目的:探讨磁共振弥散张量成像(DTI)在脑卒中早期患者下肢康复疗效中应用价值。 方法:收集广东省江门市中心医院神经内科2012年8月至2013年9月符合入选标准的患者17例,入院后均给以相同药物治疗和综合康复治疗。分别于康复治疗前和康复治疗3周后完成DTI检查,测量最大病灶侧及对侧相应部位的部分各向异性值(FA),计算FA比值(rFA)、FA不对称性(FAasy)及健患侧FA差值。同时完成Fugl-Meyer下肢运动功能评估(FMA)。观察治疗前后患侧FA、健侧FA、rFA、FAasy及健患侧FA差值的变化值与FMA变化值的相关性。 结果:康复治疗3周后,患侧FA、rFA、FAasy、健患侧FA差值及FMA评分与治疗前比较,差异均有显著性意义(P<0.05);健侧FA值与治疗前比较,差异无显著性意义(P>0.05)。康复治疗前后患侧FA和rFA的变化值与FMA变化值呈线性正相关(r=0.579,P=0.015;r=0.560,P=0.020);FAasy和健患侧FA差值的变化值与FMA变化值呈线性负相关(r=-0.530,P=0.029;r=-0.557,P=0.020);健侧FA变化值与FMA变化值不相关(r=-0.300,P=0.242)。 结论:DTI中各参数的改变与下肢运动损伤程度存在关联性,可用于评估脑卒中后皮质脊髓束的损伤程度和运动功能障碍。
关键词:磁共振弥散张量成像  脑卒中  早期  Fugl-Meyer运动功能量表  康复治疗
Predictive study of magnetic resonance diffusion tensor imaging in the rehabilitation of lower limb in patients with early stage stroke    Download Fulltext
Dept. of Neurology Three Areas of Jiangmen Central Hospital, Jiangmen City of Guangdong,529000
Fund Project:
Abstract:
      Abstract Objective:To evaluate the application value of magnetic resonance diffusion tensor imaging (DTI) in the rehabilitation of lower limbs in patients with early stroke. Method: Totally 17 patients met the inclusion criteria were collected from the Neurology Department of Jiangmen Central Hospital of Guangdong province from August 2012 to September 2013. All patients were given the same medication and comprehensive rehabilitation treatment after admission. After the completion of DTI inspection before and 3 weeks after rehabilitation training, we measured the maximum anisotropy of ipsilateral and contralateral corresponding parts(FA), calculated the ratio of FA (rFA), FA asymmetry(FAasy) and FA difference between ipsilateral and contralateral sides, respectively. Fugl-Meyer lower extremity motor function assessment (FMA) was performed simultaneously. The correlation between the change of FA, rFA, FAasy and FA difference and the change of FMA was observed before and after treatment. Result:After 3 weeks rehabilitation, we compared the ipsilateral FA, rFA, FAasy, FA difference between ipsilateral and contralateral sides and FMA score with those before treatment and differences were statistically significant (P<0.05).However, when compared with before treatment , the contralateral FA value showed no significant change after rehabilitation(P>0.05). The change of ipsilateral FA and rFA values before and after the rehabilitation exhibited a linear positive correlation with the change of FMA value (r=0.579, P=0.015,r=0.560, P=0.020,FAasy). On the contrary, the change of FAasy and FA difference between ipsilateral and contralateral sides exhibited a linear negative correlation with the change of FMA (r=-0.530, P=0.029, r=-0.557, P=0.020). The change of contralateral FA and FMA value were not related (r=-0.300, P=0.242). Conclusion:The changes of the parameters in DTI were correlated with the degree of motion injury of lower limbs. DTI can be used to evaluate motor function and corticospinal tract injury after stroke.
Keywords:diffusion tensor image  stroke  early  Fugl-Meyer motor assessment  rehabilitation
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