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• Clinical Article •
A correlation study between diffusivity of ischemic white matter fiber tract and neuro-functional recovery in patients with acute stroke by using DTI technique
YANG Shuo-hui  ZHAN Song-hua  LU fang  LI Chen  LIN Jiang 

DOI:10.3969/j.issn.1674-8034.2015.10.003.


[Abstract] Objective: To evaluate the correlation between diffusivity of ischemic white matter fiber tract and neuro-functional recovery in acute stroke patients by using DTI, and try to predict the motor outcome of these patients.Materials and Methods: Forty unilateral cerebral ischemic patients with motor dysfunction underwent MRI and DTI study within three days after the onset of illness. MRI and DTI scans were done one, two and three month after treatment. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) maps were obtained. With the reference of DW images, regions of interest (ROIs) were selected on the ischemic white matter fiber tract, and the control ROIs were selected on the contralateral homonymic white matter fiber tract. The ratios of FA and ADC (rFA and rADC) within these ROIs and infarction volume were calculated. The relationship between DTI parameters with infarction volume and national institute of health stroke scale (NIHSS) scores were assessed. According to motricity index (MI), a total of thirty-two stroke follow-up patients after one year treatment were divided into no motor deficit group and motor deficit group and DTI parameters were used to predict the motor outcome.Results: Significant differences were found regarding rFA, rADC and infarction volume of ischemic white matter fiber tract among the onset, one, two and three months of the stroke patients (F=13.84, P=0.00; F=64.57, P=0.00 and F=37.41, P=0.00). There was significantly negative correlation between rFA and NIHSS scores at the onset and one month (r=-0.59, t=-4.59, P=0.00; r=-0.34, t=-2.27, P=0.02) and between rADC and NIHSS scores at the onset (r=-0.44, t=-3.04, P=0.00). There was significantly positive correlation between rADC and NIHSS (r=0.28, t=1.83, P=0.04; r=0.39, t=2.69, P=0.00; r=0.63, t=4.99, P=0.00) and between the infarction volume and NIHSS scores (r=0.40, t=2.73, P=0.01; r=0.44, t=3.05, P=0.00; r= 0.32, t=2.13, P=0.04) at one, two and three months from the onset. There was significant correlation between the rFA of the onset, the rADC of three months treatment and MI of thirty-two stroke patients after one year (t=2.95, P=0.00 and t=2.75, P=0.01). For rADC at three months, the area under curves of ROC was 0.905.Conclusion: Our results suggest that there could be a significant correlation between the change of diffusivity of the ischemic white matter and the neuro-functional recovery in the acute stroke patients by analyzing DTI metrics. ADC values at three months after onset of the acute stroke patients may be used to predict the motor outcome.
[Keywords] Diffusion magnetic resonance imaging；Stroke；Brain ischemia；Leukoencephalopathies；White matter fiber tract injury

YANG Shuo-hui Department of Radiology, Shuguang Hosipital, Shanghai University of T.C.M, Shanghai 200021, China; Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China

ZHAN Song-hua Department of Radiology, Shuguang Hosipital, Shanghai University of T.C.M, Shanghai 200021, China

LU fang Department of Radiology, Shuguang Hosipital, Shanghai University of T.C.M, Shanghai 200021, China

LI Chen Department of Radiology, Shuguang Hosipital, Shanghai University of T.C.M, Shanghai 200021, China

LIN Jiang* Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China

*Correspondence to: Lin J, E-mail: lin.jiang@zs-hospital.sh.cn

Conflicts of interest   None.

ACKNOWLEDGMENTS  This work was part of project of National Natural Science Foundation (Youth) No. 81403204 Project of Youth research Shanghai Municipal Bureau of health No. 20114y177
Received  2015-03-17
Accepted  2015-04-30
DOI: 10.3969/j.issn.1674-8034.2015.10.003
DOI:10.3969/j.issn.1674-8034.2015.10.003.

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