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• Clinical Article •
The application research of diffusion tensor imaging and magnetic resonance spectroscopic imaging in ischemic cerebral small vessel disease
ZHANG Hui-li  LI Shi-hong  ZHANG Ying-dong  ZHOU Jun-shan  YIN Xin-dao 

Co-first Author: LI Shi-hong DOI:10.12015/issn.1674-8034.2017.06.004.


[Abstract] Objective: To investigate the medical imaging evaluative value of diffusion tensor imaging combined with magnetic resonance spectroscopy in ischemic cerebral small vessel disease.Materials and Methods: Forty-two cases of ischemic SVD were imaged with conventional MRI, DTI and MRS. Average diffusion coefficient (DCavg) and fractional anisotropy (FA) were measured symmetrically, which in the lesion regions and the contralateral normal white matter area. Then the absolute metabolite concentrations of N-acetylaspartate (NAA), total cholines (Cho), total creatines (Cr) and myo-inositol (MI) in SVD lesion regions and the normal white matter regions around the lesions were detected, and the ratios of NAA/Cho, NAA/Cr, Cho/Cr, MI/Cr were calculated. To divide the 42 lesions of ischemic SVD into groups according to the imaging display, all the indexes above mentioned of each group were statistically analyzed.Results: The 42 lesions of ischemic SVD were divided into chronic ischemic focus group (30 cases) and chronic lacunar infarction group (12 cases). The DCavg values of SVD lesions significantly raised compared with those of the contralateral normal white matter area (P<0.01), while the FA values of SVD lesions reduced (P<0.01). Neither DCavg nor FA values between chronic ischemic focus group and chronic lacunar infractions group were significantly different (P>0.05). The mean values of NAA, Cho and Cr of the SVD lesions were all less than those of the normal white matter regions around the lesions (P<0.01), but there was no significant difference of MRS metabolic values between chronic ischemic focus group and chronic lacunar infarctions group (P>0.05). Pearson correlation analysis showed that there was a negative correlation between DCavg value and FA (r=-0.383, P=0.012) in normal white matter, the FA value was positively correlated with NAA/Cho (r=0.420, P=0.006), NAA/Cr (r=0.382, P=0.012), but there was no correlation in the SVD lesions. The DCavg value was actively associated with hypertension in SVD lesions by Spearman correlation analysis (r=0.338, P=0.029).Conclusion: For the ischemic SVD, the values of DCavg, FA, NAA, Cho and Cr can reflect the micro variations and the functional damages of nerve neurolemma. Combined application of DTI and MRS could have a great contribution to clinical diagnose and pathological mechanism in ischemic SVD.
[Keywords] Diffusion tensor imaging；Magnetic resonance spectroscopy；Small vessel disease；Magnetic resonance imaging

ZHANG Hui-li School of Radiology, Jiangsu Vocational College of Medicine, Yancheng 224000, China

LI Shi-hong Department of Radiology, Yancheng Fumin hospital, Yancheng 224000, China

ZHANG Ying-dong Department of Internal Neurology, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing 210006, China

ZHOU Jun-shan Department of Internal Neurology, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing 210006, China

YIN Xin-dao* Department of Radiology, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing 210006, China

*Correspondence to: Yin XD, E-mail: y.163yy@163.com

Conflicts of interest   None.

Received  2016-11-29
Accepted  2017-01-25
DOI: 10.12015/issn.1674-8034.2017.06.004
Co-first Author: LI Shi-hong DOI:10.12015/issn.1674-8034.2017.06.004.

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