The value of MR diffusion tensor imaging on diagnosis and prognosise evaluation in patients with disorders of consciousness

doi:10.3877/cma.j.issn.2095-9141.2016.06.005

Abstract

Abstract:

Objective

To investigate the clinical application value and the changing regularity of several metrics of diffusion tensor imaging (DTI) in consciousness disorder patients(DOC).

Methods

The patient who were diagnosed with DOC(VS group was 66, MCS group was 9) were recruited at The Bayi Brain Hospital affiliated to Beijing PLA Hospital from Jun. 2014 to Dec. 2015 to examined with DTI. The evaluating metrics data of brainstem, subcortical thalamus related regions of interesting (ROI) were collected respectively. The data of ROI between the two groups were compared, then correlated the mean FA and MD value with the clinical CRS-R in ROI.

Results

The FA of the VS group was significantly lower than that at MCS group (P<0.05). The MD of the VS group was significantly higher than that at MCS group (P<0.05). The mean FA and MD value of ROI correlated with clinical CRS-R score well, expecially in thalamus.

Conclusins

DTI has certain clinical significance on imaging grading DOC. The degree of consciousness disorder greater, the MD is higher and the FA is lower.

Key words: Diffusion tensor imaging, disorders of consciousness, Vegetative state, Minimally conscious state, Prognosis evaluation

Qingxia Tao, Yi Yang, Jianghong He, Lubin Wang, Xiaoyu Xia, Chong Wang, Yong Wang, Ruxiang Xu. The value of MR diffusion tensor imaging on diagnosis and prognosise evaluation in patients with disorders of consciousness[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2016, 02(06): 341-345.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsjcswkdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-9141.2016.06.005

https://zhsjcswkdzzz.cma-cmc.com.cn/EN/Y2016/V02/I06/341

Figures/Tables 4

References 20

[1]	余丹，高坚，李景琦,等.应用临床意识量表评估意识障碍程度的敏感性[J].中华急诊医学杂志, 2012, 21(4): 406-410.
[2]	Tagliazucchi E, Chialvo DR, Siniatchkin M, et al. Large-scale signatures of unconsciousness are consistent with a departure from critical dynamics[J]. JR Soc Interface, 2016, 13(114): 20151027.
[3]	Laureys S, Schiff ND. Coma and consciousness: Paradigms（re)framed by neuroimaging[J]. Neuroimage, 2012, 61(2): 478-491.
[4]	Giacino JT, Fins JJ, Laureys S, et al. Disorders of consciousness after acquired brain injury: the state of the science[J]. Nat Rev Neurol, 2014, 10(2): 99-114.
[5]	Schnakers C, Vanhaudenhuyse A, Giacino J, et al. Diagnostic accuracy of the vegetative and minimally conscious state: clinical consensus versus standardized neurobehavioral assessment[J]. BMC Neurol, 2009, 9: 35.
[6]	Luaute J, Maucort-Boulch D, Tell L, et al. Long-term outcomes of chronic minimally conscious and vegetative states[J]. Neurology, 2010, 75(3): 246-252.
[7]	Giacino JT, Kalmar K. Diagnostic and prognostic guidelines for the vegetative and minimally conscious states[J]. Neuropsychol Rehabil, 2005, 15(3-4): 166-174.
[8]	王双坤，戴建平，马军,等.磁共振弥散张量成像对弥漫性轴索损伤的研究[J].中国医学影像技术, 2005, 21(12): 1799-1801.
[9]	易亚辉，周海航，陆忠烈,等.磁共振弥散张量成像对早期弥漫性轴索损伤的诊断价值[J].中国医学计算机成像杂志, 2015, 21(3): 224-227.
[10]	康晓刚.意识障碍患者脑功能评估及预后判别研究[D].第四军医大学, 2014.
[11]	戴懿，朱熠，汪兵,等.意识障碍患者的神经功能成像--评价,预后和局限性[J].罕少疾病杂志, 2016, 23(2): 61-64.
[12]	包贇.脑干反射对脑创伤长期意识障碍患者的清醒预测及预后评估[D].南方医科大学, 2012.
[13]	王蕴坤.脑损伤昏迷后丘脑连接结构变化与意识障碍的相关性研究[D].第二军医大学, 2013.
[14]	刘永，邹元杰，刘宏毅,等. DTI技术在微血管减压术治疗三叉神经痛中的应用价值[J].临床神经病学杂志, 2015, 28(5): 326-329.
[15]	李香春，刘江红，王海平,等.弥散张量成像对遗忘型轻度认知障碍诊断和预后评估的价值[J].中国全科医学, 2016, 19(11): 1282-1287.
[16]	徐小亭，林岚，吴水才,等.基于DTI影像建立大脑老化预测模型的研究[J].中国医疗设备, 2014, (12): 19-23.
[17]	Schnakers C, Vanhaudenhuyse A, Giacino J, et al. Diagnostic accuracy of the vegetative and minimally conscious state: clinical consensus versus standardized neurobehavioral assessment[J]. BMC Neurol, 2009, 9: 35.
[18]	Fernandez-Espejo D, Soddu A, Cruse D, et al. A role for the default mode network in the bases of disorders of consciousness[J]. Ann Neurol, 2012, 72(3): 335-343.
[19]	张祥，李葆青，李坤成,等.探讨健康成人视辐射的磁共振弥散张量成像与年龄的相关性[J].中国医学影像技术, 2012, 28(5): 843-847.
[20]	王培东.昏迷与植物状态诊断治疗学[M].北京:人民卫生出版社, 2008: 236-237.

组别	例数	脑干		丘脑		皮层下
组别	例数	部分各向异性值	平均弥散率值	部分各向异性值	平均弥散率值	部分各向异性值	平均弥散率值
植物状态组	66	0.164±0.0619	0.0012±0.0003	0.1996±0.0650^a1	0.0019±0.0003	0.2055±0.0781^a1	0.0015±0.0003^b2
微意识组	9	0.2150±0.0434	0.0010±0.0002	0.2457±0.0591^a1	0.0016±0.0004^b1	0.2639±0.0388^a1	0.0013±0.0003
t值	?	2.386	1.936	1.999	2.701	2.197	2.011
P值	?	0.020	0.047	0.049	0.009	0.031	0.048

组别	例数	脑干		丘脑		皮层下
组别	例数	部分各向异性值	平均弥散率值	部分各向异性值	平均弥散率值	部分各向异性值	平均弥散率值
植物状态组	66	0.164±0.0619	0.0012±0.0003	0.1996±0.0650^a1	0.0019±0.0003	0.2055±0.0781^a1	0.0015±0.0003^b2
微意识组	9	0.2150±0.0434	0.0010±0.0002	0.2457±0.0591^a1	0.0016±0.0004^b1	0.2639±0.0388^a1	0.0013±0.0003
t值	?	2.386	1.936	1.999	2.701	2.197	2.011
P值	?	0.020	0.047	0.049	0.009	0.031	0.048

感兴趣区	例数	部分各向异性值		平均弥散率值
感兴趣区	例数	R系数	P值	R系数	P值
脑干	75	0.574	0.046	-0.438	0.050
丘脑	75	0.603	0.021	-0.555	0.041
皮层下	75	0.640	0.037	-0.298	0.013

感兴趣区	例数	部分各向异性值		平均弥散率值
感兴趣区	例数	R系数	P值	R系数	P值
脑干	75	0.574	0.046	-0.438	0.050
丘脑	75	0.603	0.021	-0.555	0.041
皮层下	75	0.640	0.037	-0.298	0.013

Please choose a citation manager

Content to export