[Can diffusion tensor imaging predict the functional outcome of supra-tentorial stroke?].
We used diffusion tensor imaging (DTI) to assess wallerian degeneration of the pyramidal tract after the onset of supra-tentorial stroke, and correlation of the extent of Wallerian degeneration with the motor function at 3 months after stroke. Twenty eight patients with supra-tentorial acute stroke were examined, two weeks and one month after stroke by DTI. We measured fractional anisotropy(FA) of affected side/ unaffected side (FA ratio) in the cerebral peduncle. We used modified Rankin Scale (mRS) for assessment of motor function at 3 months after stroke. FA ratio was significantly reduced at 2 weeks after stroke (0.833 +/- 0.146) compared to on admission (0.979 +/- 0.0797). But no significant change of FA ratio was seen between two weeks and one month after stroke in 7 cases examined (0.758 +/- 0.183 vs. 0.754 +/- 0.183). In all patients in whom the FA ratio was under 0.8 at 2 weeks after stroke, motor function showed poor recovery (mRS 4 and 5) at 3 months after stroke. When FA ratio was over 0.8 at 2 weeks after stroke, motor function at 3 months after stroke showed good recovery (mRS 0 to 3) expect for three elderly patients. With the use of DTI, Wallerian degeneration could be detected in the corticospinal tracts at midbrain level during the early phase of supra-tentorial stroke. We conclude that DTI may be useful for early prediction of motor function prognosis in patients with supra-tentorial acute stroke.
Maeda
Takahiro
T
Department of Neurosurgery, Tomakomai Nisshou Hospital.
Ishizaki
Ken-ichi
K
Yura
Shigeki
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016880:Anisotropy; D001921:Brain / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011712:Pyramidal Tracts / Q000473:pathology; D020521:Stroke / Q000175:diagnosis*; D000071939:Stroke Rehabilitation; D014855:Wallerian Degeneration / Q000175:diagnosis