目的：利用磁共振弥散张量成像（DTI）探究卒中后淡漠发病的结构基础。方法：将54例缺血性脑卒中恢复期患者根据淡漠的临床诊断分为淡漠组（n＝31）与非淡漠组（n＝23），并采集颅脑 T1、T2以及 DTI 序列MR影像；比较两组间年龄、性别、教育程度、神经功能缺损（NIHSS）评分及梗塞灶位置，然后利用 DTI 进行基于体素的分析（VBA）以探究卒中后淡漠结构基础。结果：AES-C 评分存在两组间存在统计学差异（P＝0．00），余各项资料则未发现组间差异。左侧前部放射冠区、胼胝体膝部、压部、毯部的FA值在淡漠组明显下降（P＜0．05）。结论：左侧额叶-皮质下环路及胼胝体膝部、压部、毯部白质结构的破坏可能与卒中后淡漠有关。%Objective: To explore the structural bases of the post-stroke apathy using diffusion tensor imaging (DTI). Methods: 54e patients with ischemia stroke during recovery phase were selected, and were grouped into apathy (n=31) and non-apathy (n=23) groups using clinical diagnostic criteria. All the patients’ brain MR images were collected, including T1, T2 and DTI sequences. Differences of age, gender, education year, National Institutes of Health Stroke Scale (NIHSS) and the location of the stroke between two groups were compared, and then voxel based analysis (VBA) of DTI was used to explore the structural bases of post-stroke apathy. Results: Statistical differences existed in the comparison of the AES-C scores (P = 0.00), but not in the comparisons of the other factors. The FA value of the left anterior corona radiata, the genu, splenium and tapetum of corpus callosum were found decreased in the apathy group(P < 0.05). Conclusion: The disconnection of the frontal-subcortical circuits and the genu, splenium and tapetum of corpus callosum may be associated with post-stroke apathy.
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