目的：探讨磁共振弥散张量成像（DTI）与弥散张量纤维束示踪技术（DTT ）对早期弥漫性轴索损伤（DAI）的诊断应用价值。方法对22例 DAI 早期（伤后10天内）患者（DAI 组）及12例正常志愿者（对照组）分别行常规 MR 扫描及弥散张量成像扫描。在 FA 图上分别测量 DAI 组及对照组双侧半球白质感兴趣区（胼胝体压部、胼胝体膝部、内囊前肢、内囊后肢）部分各向异性（FA）值，将两组感兴趣区（ROI）平均 FA 值的差异进行比较，并对 DAI 组 FA 值与临床GCS 评分进行相关性分析。运用弥散张量纤维束成像显示通过病灶的纤维束特征。结果病变组与对照组比较，DAI早期 FA 值（胼胝体压部0．647±0．069、胼胝体膝部0．615±0．043、内囊前肢0．541±0．065、内囊后肢0．639±0．035）较对照组（胼胝体压部0．748±0．045、胼胝体膝部0．729±0．058、内囊前肢0．622±0．038、内囊后肢0．667±0．027）FA 值显著降低（ P ＜0．001）。胼胝体压部 FA 值的变化与 GCS 评分呈正相关（ r ＝0．736，P ＝0．001）。 DTT 较好显示感兴趣区白质纤维束形态，更直观显示脑白质损伤程度。结论 DTI 联合 DTT 是 DAI 患者检查的敏感方法，FA 值评估是DAI 程度的重要依据，DDT 可观察神经纤维束受损范围。%Objective To investigate the clinical application value of magnetic resonance diffusion tensor imaging (DTI) and diffusion tensor tracking (DTT) for the diagnosis of acute diffuse axonal injury (DAI) .Methods Routine magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) were applied to 22 patients with acute TAI (DAI group within ten days after onset) and 12 healthy volunteers (control group) .The FA value was meaured in bilatreal ROI of trauma and control group ,the mean FA value was compared between the two group and the mean FA value was correlated with the clinical glasgow coma score(GCS) .Visualization of the fibertract was achieved by postprocessing the acquired DTI data .Results Compared with control group ,there were significant decreases of the FA value between the acute group of DAI (FA values of splenium of corpus callosum in 0 .647 ± 0 .069 ,genu of corpus callosum in 0 .615 ± 0 .043 ,an‐terior internal capsule in 0.541 ± 0 .065 ,posterior internal capsule in 0 .639 ± 0 .035) and the control group (FA values of splenium of corpus callosum in 0 .748 ± 0 .045 ,genu of corpus callosum in 0 .729 ± 0 .058 ,anterior internal capsule in 0.622 ± 0 .038 ,posterior internal capsule in 0 .667 ± 0 .027) ( P < 0 .001) .The FA value of splenium of corpus callosum positively correlated with GCS in the acute group of DAI ( r = 0 .736 ,P = 0 .001) .Combination of DTT and diffusion ten‐sor ellipsoid showed offending alba fiber bundle well depicting lesion of alba area more directly to some extent .Conclusion Combination of DTI and DT T is sensitive check sequence with DAI patients .FA value is assessment for the severity of DAI patients and effective basis .DTT can be used to observe the damaged nerve fibers range .
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