Diffusion tensor tractography in prognostic evaluation of patients with cerebral vascular disease

Objective To observe the impairment of corticospinales in the acute cerebrovascular events,and analyze the changes of motor function for the prognostic judging.Methods 18 patients were tested by the diffusion tensor tractography(16 ischemic stroke,2 hemorrhagic stroke),to detect the succession and impairment of tractus.We also graded the muscle strength and scored the nervous system function at the stage of onset,2 weeks after the onset,1 month later and 2 months later.Results There were 2 grades on the condition of the injured CST.5 cases were evaluated as Grade 1,whose CST were integrity.13 cases were Grade 2 because of the discontinuance of CST.Injured degree of CST in 16 patients with ischemic stroke was significantly associated with hemiplegia muscle strength and NIHSS score(P0.05),the turnover of the NIHSS score at two month after onset showed significant difference with the injury degree of the CST(P=0.0202).The muscle strength of the patients with hemorrhage had complete CST recovery more quickly,and the NIHSS scores at different stages were lower,though their paralysis were complete.Injured degree of CST was significantly associated with hemiplegia muscle strength and the NIHSS scores at different stages(at the stage of onset,a month after onset,two month after onset,P0.05).The turnover of NIHSS scores at the time of 2 months after onset had significant statistic variance with the grade of the injured CST(P=0.0269).Conclusion The 3D images presented by the tractography of diffusion tensor imaging can describe the profile of CST more clearly and directly,which can be used to evaluate the impairment of CST at the early stage of acute cerebrovascular events,favoring the prognostic judgment in the rehabilitative therapy of cerebrovascular disorders.