Evaluation of Cortical Spinal Tract Injury and Prognosis of Cerebral Infarction with Diffusion Tensor Tractography

Objective To analyze relationship between injury of CST and the prognosis of cerebral infarction by diffusion tensor.Materials and Methods 35 patients of cerebral infarction involved basal ganglia,internal capsule or corona radiate received diffusion tensor imaging and diffusion tensor tractography(DTT).FA value of CST in the infarcted regions and corresponding contralateral normal regions were measured,and spatial relationship between the infarction and CST was analyzed,displacement,continuity and injured conditions of CST were observed.The prognosis of cerebral infarction was measured with manual muscle testing(MMT).The impairment degree of CST and correlation of the clinical outcome was analyzed.Results Three patterns of CST involvement were identified:close,partly involved and completely involved.Different pattern had different clinical outcome,the FA value of CST closed to the infarction decreased slightly,which had a fully recovery.The FA value of CST completely involved was significant lower than that of corresponding contralateral CST(P0.001),these patients had the worst prognosis and their myodynamia had not be recovered after therapy.Injured degree of CST was significantly negative correlation with MMT(r=-0.917,P0.01).Conclusion DTT can directly display injury of CST,and CST injury is closely correlated with the prognosis of cerebral infarction.