Abstract：【Objective】To explore the features and differences of magnetic resonance diffusion tensor imaging (DTI) in patients with acute cerebral infarction (ACI) at different time points. 【Methods】A total of 89 ACI patients treated in the two hospitals were selected and divided into the ultra-acute stage (onset ≤6 h) with 39 cases and the acute stage (6 h<onset≤3 d) with 50 cases based on the time of onset. The DTI parameters, including Fractional Anisotropy (FA), Mean Diffusion Coefficient (DCavg), and Isotropy (ISO) of lesion side and contralesional side were compared. Additionally, the values of lesion-side FA, DCavg, and ISO in diagnosing ultra-acute stage ACI were assessed. 【Results】 In the acute stage, the signal intensity on the FA image decreased and the brain white matter fibers were interrupted and destroyed, while no significant signal change was observed in the ultra-acute stage. In the ultra-acute stage, the signal on the DCavg image decreased and the brain white matter fibers were destroyed, whereas in the acute stage, brain white matter fibers were interrupted and reduced on the DCavg image. The FA value on the lesion side in the ultra-acute stage was higher than that in the acute stage, and the DCavg and ISO values were lower than in the acute stage (P<0.05). The DCavg value on the contralesional side in the ultra-acute stage was lower than in the acute stage, and the ISO value was higher (P<0.05). The DCavg values on the contralesional side in both the ultra-acute and acute stages were higher than on the lesion side, and the ISO values were lower (P<0.05). The FA value on the contralesional side in the acute stage was higher than on the lesion side (P<0.05). The Receiver Operating Characteristic (ROC) curve analysis showed that the Area Under the Curve (AUC) of the lesion-side FA value, DCavg value, ISO value alone and in combination for diagnosing ultra-acute stage ACI were 0.812, 0.842, 0.848, and 0.916 respectively. 【Conclusion】There are significant differences between the characteristics of DTI images in the acute stage and ultra-acute stage ACI patients. The DTI parameters, including FA, DCavg, and ISO values, can assist in diagnosing ACI staging, and their combined diagnostic efficacy is better.
高强, 黄晓旗, 马小伟. 不同时期急性脑梗死患者磁共振弥散张量成像特征及鉴别价值[J]. 医学临床研究, 2023, 40(10): 1459-1462.
GAO Qiang, HUANG Xiaoqi, MA Xiaowei. Magnetic Resonance Diffusion Tensor Imaging Characteristics and Differentiation Value of Acute Cerebral Infarction Patients at Different Time Points. JOURNAL OF CLINICAL RESEARCH, 2023, 40(10): 1459-1462.
[1] 汤奉琼,李洪义. 老年超急性与急性缺血性脑梗死患者磁共振弥散张量成像特征比较[J].中国老年学杂志,2020,40(8):1596-1599. [2] MORENO-ANDRADE T, GARZA-VILLARREAL E. Diffusion tensor imaging of the corticospinal pathway and its association with the prognosis of acute cerebral infarction:experience with a cohort in Mexico[J].Rev Neurol,2021,72(1):16-22. [3] 陈历,季一飞,蒋炳虎,等. 急性脑梗死早期血清EphA2蛋白、静息态Bold-fMRI、DTI参数动态变化在肢体运动功能恢复中的预测价值[J].中国病案,2022,23(4):98-102. [4] BERNDT M T, PURNER D, MAEGERLEIN C, et al. Basal ganglia versus peripheral infarcts:predictive value of early fiber alterations[J].AJNR Am J Neuroradiol,2021,42(2):264-270. [5] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,51(9):666-682. [6] 钟光耀,张文,黎美琪,等. 急性脑梗死患者院外急救时间分布及其延误影响因素分析[J].中国急救复苏与灾害医学杂志,2022,17(3):328-330. [7] MIRCHANDANI AS, BEYH A, LAVRADOR JP, et al. Altered corticospinal microstructure and motor cortex excitability in gliomas:an advanced tractography and transcranial magnetic stimulation study[J].J Neurosurg,2020,134(5):1368-1376. [8] ABHINAV K, NIELSEN T H, SINGH R, et al. Utility of a quantitative approach using diffusion tensor imaging for prognostication regarding motor and functional outcomes in patients with surgically resected deep intracranial cavernous malformations[J].Neurosurgery,2019,25(9):1064-1067. [9] 张迷,杨燕,郑卫华. DTI联合DWI在诊断早期脑梗死缺血半暗带中的应用[J].中国CT和MRI杂志,2019,17(8):15-17. [10] PANARA V, NAVARRA R, MATTEI P A, et al. Correlations between cervical spinal cord magnetic resonance diffusion tensor and diffusion kurtosis imaging metrics and motor performance in patients with chronic ischemic brain lesions of the corticospinal tract[J].Neuroradiology,2019,61(2):175-182. [11] LIANG S, ZHANG J, ZHANG Q, et al. Longitudinal tracing of white matter integrity on diffusion tensor imaging in the chronic cerebral ischemia and acute cerebral ischemia[J].Brain Res Bull,2020,154(2):135-141. [12] 陶欣,王东,殷云志. DTI对急性脑梗死患者早期诊断及临床转归的预测价值[J].中国CT和MRI杂志,2019,17(5):22-25. [13] 吴艳梅,张德智,沈松柏,等. 磁共振扩散张量成像在不同时期急性缺血性脑梗死鉴别中的应用价值研究[J].实用心脑肺血管病杂志,2022,30(2):107-111.
2023, Vol. 40 
