Application of DTI to evaluate the mT BI value of different social supports
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摘要: 目的 探究磁共振扩散张量成像(diffusion tensor imaging,DTI)在检查评估不同社会支持度轻度颅脑损伤(mild traumatic brain injury,mTBI)患者预后中的应用价值。 方法 选择2016年1月—2018年1月于温州医科大学附属第二医院急诊外科及神经外科就诊的mTBI患者99例,按照入院时社会支持评定量表(SRSS)得分(≥20分设置为区分点)分为高社会支持度组(54例)及低社会支持度组(45例),评估2组患者简易精神状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)得分,对其进行DTI检测,记录其各项异性分数(FA)及表观扩散系数(ADC)并进行对比。 结果 ①高社会支持度组患者MMSE及MoCA量表得分均高于低社会支持度患者(均P<0.05);②低社会支持度患者两侧额叶、两侧颞叶、胼胝体膝部FA值出现下降,与高社会支持度组患者比较差异有统计学意义(均P<0.05);③低社会支持度患者额叶左侧白质、额叶右侧白质、颞叶左侧白质、颞叶右侧白质、胼胝体膝部ADC值高于高社会支持度患者,差异有统计学意义(均P<0.05)。 结论 不同社会支持度mTBI患者认知状态、认知功能会存在明显差异,同时DTI检测FA及ADC值也有部分差异,认知障碍可能与额叶、颞叶、胼胝体白质受损密切相关。Abstract: Objective To explore the value of diffusion tensor imaging(DTI) in evaluating the prognosis of mild traumatic brain injury(mTBI) patients with different social support. Methods From January 2016 to January 2018, 99 patients with mTBI in the departments of emergency surgery and neurosurgery of the Second Affiliated Hospital of Wenzhou Medical University, were divided into high social support group(54 cases) and low social support group(45 cases) according to their social support rating scale(SRSS) score(>20). The scores of Easy Mental State Examination Scale(MMSE) and Montreal Cognitive Assessment Scale(MoCA) were measured by DTI. Anisotropic score(FA) and apparent diffusion coefficient(ADC) were recorded and compared. Results ①The scores of MMSE and MoCA in patients with high social support were higher than those in patients with low social support(all P<0.05); ②The FA values of frontal lobe, medial temporal lobe and knee of corpus callosum in patients with low social support decreased significantly(all P<0.05). ③The ADC values of left white matter of frontal lobe, right white matter of frontal lobe, left white matter of temporal lobe and right white matter of temporal lobe in patients with low social support were higher than those in patients with high social support(all P<0.05). Conclusion The cognitive status and cognitive function of mTBI patients with different social support levels are significantly different, and the FA and ADC values of DTI are also partly different. Cognitive impairment is closely related to the impairment of white matter in frontal lobe, temporal lobe and corpus callosum.
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Key words:
- Diffusion tensor imaging /
- Social support /
- Mild traumatic brain injury
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