Clinical Application Of Diffusion Tensor Imaging In Patients With Persistent Vegetative State

Objective:Diffusion tensor imaging(DTI)Atlas-based analysis(ABA)method was used to study the characteristics of brain white matter changes in patients with persistent vegetative state(PVS),and the functional neuroanatomical basis for the the possible pathogenesis and prognosis of patients with persistent vegetative state was provided.Methods:4 PVS patients(PVS group)and 11 Healthy control(HC group)who met the test criteria were included,and DTI scan was performed by philips3.0t magnetic resonance scanner.DTI raw data was post-processed by PANDA software.ABA method was used to calculate the fractional anisotrophy(FA)and mean diffusivity(MD)of white matter fibers in the whole brain and the correlation between FA value,MD value and consciousness Recovery was compared in 4 patients with Coma Recovery scale-revised(CRS-R)score.Then,the FA and MD values of the PVS group and HC group were tested by independent sample T test(P<0.05),and the correlation between the FA and MD values with differences and CRS-R score was analyze.Results:1.The CRS-R scores of 4 PVS patients were improved after 2 months of comprehensive rehabilitation treatment,including 1 patient with the largest total white matter average FA value and the smallest MD value,indicating that the white matter fiber injury was mild,the improvement of the patient’s CRS-R score was the most obvious,and the patient’s total white matter average FA value was the smallest and the largest,indicating that the brain white matter fiber injury was serious,and the improvement of the patient’s CRS-R score was not obvious.2.Compared with HC group,the PVS group had middle cerebellar peduncle,pontine crossing tract,corpus callosum,genu,body and splenium,fornix,bilateral corticospinal tract,bilateral cerebellum peduncle,bilateral cerebral peduncle,bilateral anterior limb of internal capsule,bilateral posterior limb of internal capsule,bilateral retrolenticular part of internal capsule,bilateral anterior,superior and posterior radiation crowns,bilateral posterior thalamic radiation,bilateral sagittal stratum,bilateral external capsule,bilateral cingulate gyrus,bilateral hippocampus,bilateral fornix/stria terminalis,bilateral superior longitudinal fasciculus,bilateral superior fronto-occipital fasciculus,bilateral uncinate fasciculus,bilateral tapetum multiple cerebral white matter area a FA value lower(P<0.05).Except bilateral hippocampus,FA values in other brain regions were positively correlated with CRS-R score.3.Compared with HC group,the PVS group had middle cerebellar peduncle,the genu of corpus callosum,fornix,left cerebellum peduncle,bilateral anterior limb of internal capsule,right retrolenticular part of internal capsule,bilateral anterior,left superior and left posterior radiation crowns,right sagittal stratum,left cingulate gyrus,left hippocampus,bilateral fomix/stria terminalis,bilateral superior longitudinal fasciculus,bilateral superior fronto-occipital fasciculus,bilateral uncinate fasciculus,left tapetum multiple cerebral white matter area a MD value lower(P<0.05).The MD values of all brain regions were negatively correlated with the CRS-R score.Conclusions:1.There is a positive/negative correlation between FA value and MD value and CRS-R score,and may be used as an indicator to predict the prognosis of patients with plant status;2.Chronic disorders of consciousness in patients with vegetative states may be associated with extensive damage to white matter microstructures.