The Role Of DTI And DTT In The Evaluation Of Motor Function Prognosis In Patients With Basal Ganglia Intracerebral Hemorrhage

BackgroundThe diffusion tensor imaging(DTI)and diffusion tensor tractography(DTT)are the only imaging techniques for noninvasive observation of the changes of nerve fiber bundles at present.It has been used in other neurological diseases,but it is rarely used in cerebral hemorrhage.DTT technology can be used to quantify CST damage.This parameter is more intuitive than the parameterFA,and more accurate than CST damage classification.This study aims to explore the value of FA value and quantitative CST fiber bundles in the evaluation of motor function prognosis after basal ganglia intracerebral hemorrhage,in order to provide some value imformation for the clinical evaluation of motor function prognosis.ObjectiveTo investigate the role of DTI and DTT in the evaluation of motor function prognosis after basal ganglia intracerebral hemorrhage.MethodsThe patients with basal ganglia cerebral hemorrhage within 3 days of onset who underwent DTI and DTT examination in 988 Hospital of joint service support force of PLA were selected as the experimental group,and the data of 10 normal people were selected as the control group.The number of CST fiber bundles,rFA and CST grade were detected respectively.The prognosis was evaluated by Fugl Meyer assessment(FMA)at 3 months after intracerebral hemorrhage.According to the FMA score,the patients were divided into good prognosis group(FMA ≥ 96)and poor prognosis group(FMA < 96).The differences of CST fiber numbers,rFA and CST grades among the good prognosis group,the poor prognosis group and the control group were compared.ResultsThere was a significant difference in the number of CST between the experimental group and the control group(t= 7.291,P<0.05).There was significant difference in rFA between the control group and the experimental group(t=11.320,P<0.05).The CST grades of the control group and the experimental group were significantly different(Z = 4.488,P<0.05).The difference of CST between the good and the poor prognosis group was significant(t=2.768,P<0.05);rFA difference between the good and the poor group was significant(t=2.960,P<0.05);the difference of CST classification between the good and the poor prognosis group was significant(Z=2.140,P<0.05).The relative number of remaining CST fibers was positively correlated with FMA score(r= 0.809,P<0.05).rFA was positively correlated with FMA score(r= 0.784,P<0.05).CST grade was negatively correlated with FMA score(r=-0.785,P<0.05).The area under ROC curve of relative number of remaining CST fibers,rFA and CST grading were 0.882,0.840 and 0.799(P < 0.05),respectively.It can be seen that the number of CST fibers,rFA and CST grade are closely related to the prognosis of basal ganglia hemorrhage.The larger the number of CST and rFA means the better the prognosis.The higher the CST grade,the worse the prognosis.The accuracy of the three parameters in predicting prognosis was: CST fibers number > RFA > CST grade.ConclusionsDTI and DTT can assess the prognosis of motor function after basal ganglia intracerebral hemorrhage.The higher relative number of remaining CST and the higher the rFA value,the better the prognosis,the higher the CST grade,the worse the prognosis.The prognostic value of the three indicators for motor function is as follows: relative number of remaining CST >rFA>CST grade.The relative number of remaining CST is intuitive and quantitative,and it is a better indicator for assessing sports function impairment.