Evaluation Of DTI In The Recovery Of Motor Function After Basal Ganglionic Cerebral Hemorrhage

Objective To evaluate the clinical application of diffusion tensor imaging(DTI)combined with functional neuronavigation(igns)in the recovery of limb motor function in patients with basal ganglia intracerebral hemorrhage after microsurgical hematoma removal by small bone window.Methods 40 patients with ICH in basal ganglia were randomly divided into two groups: microsurgery group(20 cases)and drug treatment group(20 cases).The microsurgery group underwent the removal of intracerebral hematoma under the small bone window microscope within 1-3 days after the onset of the disease.CT examination was reexamined one day after the operation.The drug treatment group received standard drug treatment,such as nutrition,hemostasis,reducing intracranial pressure and so on.All patients were examined by DTI 2 weeks after the onset of the disease,and then input the original DTI data into the functional IGNS to get the FA values of each group’s bleeding side,healthy side,posterior limb of internal capsule and cerebral foot,and the remaining number of cortical spinal tract(CST)through the calculation software,and then compare the microsurgery group with the drug treatment group;6 months later,follow up the patients in each group,and ask a professional neurorehabilitation specialist ADL was used to evaluate the motor function of each group.Result After reexamination of CT in the operation group,the hematoma clearance rate was more than 85%,and the hematoma clearance was satisfactory.In the microsurgery group,the FA values of CST in the two regions of interest(inner capsuleand cerebral foot)were(0.447 ± 0.13)and(0.416 ± 0.14)respectively.In the drug treatment group,the FA values of CST in the corresponding regions were(0.283 ± 0.12)and(0.280 ± 0.11)respectively.The FA value of the region of interest in the microsurgery group was significantly increased compared with the drug treatment group(P < 0.05).These results show that the destruction of CST at the internal capsule can be effectively reduced by microsurgery after the removal of hematoma in the focus area,and most of CST compressed and displaced by hematoma can be reduced.The results showed that there was a high correlation between the two(r = 0.639,P < 0.01).Conclusion Compared with the simple drug therapy,the effect of micro hematoma clearance surgery on the treatment of cerebral hemorrhage in basal ganglia is significant;observing the three-dimensional CST tracing image after the fusion of DTI imaging technology and functional nervous system can reflect the morphological changes of CST after cerebral hemorrhage;using the FA value obtained by DTI combined with igns and the relative number of CST remaining entries obtained by operation software can be used as basal ganglia The reliable index of motor nerve function recovery 6 months after the removal of micro hematoma in patients with cerebral hemorrhage.