Application Of Diffusion Tensor Imaging In The Evaluation Of Therapeutic Efficiency For Hypertensive Intracerebral Hemorrhage With Minimally Invasive Surgery And Prognosis

Objective To evaluate the efficacy of CT-guided hematoma puncture and drainage in the treatment of HICH and the value of DTI and DTT in evaluating the prognosis of HICH.Methods Select 47 HICH patients who were hospitalized in the neurosurgery department of Ningxia people’s Hospital From February 2014 to February 2017.Patients were divided into minimally invasive group(n=27)and non-operative group(n=20)according to the wishes of family members.All patients were given ECG monitoring,oxygen inhalation,atomization,neuronutrition,acid suppression,fluid replacement,hemostasis,dehydration,intracranial pressure control and other general symptomatic treatment.The patients in the minimally invasive operation group underwent CT-guided hematoma puncture and drainage within 7 to 24 hours after the onset of the disease.All the patients underwent DTI scanning within24 hours after the onset of the disease and1 month after treatment.The value of fractional anisotropic(FA)of the Cortical spinal tract(CST)were measured,and the DTT imaging was obtained by post-data processing.at the same time,NIHSS score and PG score were calculated.According to the changes of NIHSS score,PG score,FA value and DTT image of CST before and after treatment in two groups of patients,To evaluate The effect of CT-guided hematoma puncture and drainage on HICH.And analyzed the relationship between CST injury grade and NIHSS score and PG score after 1 month treatment to evaluate the value of DTI and DTT in evaluating the short-term prognosis of HICH patients.Result There was no significant difference(P>0.05)contrastively in sex composition,age,hematoma volume,admission NIHSS score and PG score,FA value within24 hours after the onset of the disease between the two groups.After one month of treatment,The FA value in the minimally invasive operation group was significantly higher,and The NIHSS score and PG score were significantly lower than that in the non-operative group(P<0.05).One month after treatment,DTT images showed that the number of CST fiber bundle in the minimally invasive operation group was significantly higher than that in the non-operative group.At the same time,the recovery of limb muscle strength in patients with low level of CST injury was also good.There was a significant positive correlation between CST injury grade and NIHSS score and PG score1 month after treatment(r=0.641,p<0.001;r=0.793,p<0.001).Conclusion The effect of aspiration of CT-guided hematoma puncture and drainage is better than that in non-operative treatment.Therefore,we should actively implement minimally invasive surgery for HICH patients with moderate bleeding(20-40ml)in the basal ganglia and neurologic impairment.DTI scan within24 hours in HICH patients can roughly predict the recovery of limb motor ability.