The Analysis Of Magnetic Resonance Diffusion Tensor Imaging In The Acute Stage Of Cerebral Hemorrhage

Objective: Assessing injuries of corticospinal tract(CST) of posterior limbs of internal capsule and cerebral peduncle for patients with intracerebral hemorrhage(ICH) in acute stage by Diffusion tensor imaging(DTI) technology, and analyzing the correlation between injuries status and neurological deficits, to explore DTI technology applications in the acute stage of ICH.Methods: Screening ICH patients with basal ganglion region cerebral hemorrhage who were hospitalized in Department of Neurology at the Second Affiliated Hospital of Dalian Medical University between December 2013 and February 2015, at the onset of the acute phase(2 to 7 days) taking multiple sequence Magnetic resonance imaging(MRI) scan, including conventional T1-weighted imaging(T1WI), T2-weighted imaging(T2WI), Diffusion weighted imaging(DWI), Fluid-attenuated inversion recovery sequence(FLAIR) and DTI examination, based on Region of inner Interest(ROI) to observe fractional anisotropy(FA) imaging of symmetrical CST in ipsilateral and contralateral limb capsule and cerebral peduncle region, and to measure the FA values. Using the United States National Institutes of Health Stroke Scale(NIHSS) for patients to assess neurological deficit scores, and comparing FA value between ipsilateral and contralateral regions, to analyze correlation between ipsilateral and contralateral FA value ratio(r FA) and NIHSS score.Results:1. There were totally 18 patients in this study, whose amount of bleeding were less than 20ml(according to Tada formula) and the average blood loss was 7.07 ml. Hemorrhage showed mixed signals in T1 WI and low signals in T2 WI, FLAIR and DWI, and the edema area around the hematoma showed high signals. There were not abnormal signal changes in cerebral peduncle region. In ipsilateral internal capsule region CST of FA imaging showed three cases having interruption, 15 cases having compressive deformation and displacement; in ipsilateral cerebral peduncle region CST of 18 cases showed completely and clearly without interruption and significant compressive deformation and displacement.2. Comparing FA values of ipsilateral and contralateral CST in posterior limbs of internal capsule region Z =-1.161, differences were statistically significant(P < 0.01), comparing FA values of ipsilateral and contralateral CST in cerebral peduncle region Z =-1.898, differences were no significant(P > 0.05).3. There was negative correlation between r FA values of CST and NIHSS score in posterior limbs of internal capsule(r = 0.478, P = 0.478), there was no correlation between r FA values of CST and NIHSS score in cerebral peduncle(r = 0.037, P = 0.037).Conclusion:1. In ICH acute stage, there are injuries of CST in posterior limbs of internal capsule region, and the extent of injuries associates with the level of neurological impairment, which can reflect clinical severity of neurological dysfunction.2. In ICH acute phase, there are no obvious injuries of CST in ipsilateral cerebral peduncle, indicating Wallerian degeneration in the cerebral peduncle has not yet occurred in the acute stage of ICH.3. DTI technology can accurately assess the extent of CST’s injuries of patients with ICH in acute stage, and also can provide quantitative indicators to evaluate neurological functional impairment of patients with ICH in acute stage.