Preoperative diffusion tensor imaging in predicting motor function outcomes in patients with moderate-volume basal ganglia cerebral hemorrhage
10.3760/cma.j.cn115354-20240312-00154
- VernacularTitle:弥散张量成像对中等量高血压性基底节区脑出血患者运动功能预后的评估作用研究
- Author:
Zhenyong LI
1
;
Yi SUN
;
Wengang LI
;
Hu XIAO
;
Liang FENG
;
Shihui JIN
Author Information
1. 郴州市第一人民医院神经外科，郴州 423000
- Keywords:
Hypertension basal ganglia hemorrhage;
minimally invasive puncture and drainage;
Diffusion tensor imaging;
Fractional anisotropy
- From:
Chinese Journal of Neuromedicine
2024;23(6):598-602
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of preoperative diffusion tensor imaging (DTI) in predicting motor function outcomes in patients with moderate-volume basal ganglia cerebral hemorrhage after minimally invasive puncture and drainage.Methods:A retrospective study was performed; 54 patients with moderate-volume hypertensive basal ganglia hemorrhage (30-50 mL) admitted to Department of Neurosurgery, First People's Hospital of Chenzhou from March 2018 to December 2019 were enrolled. All patients accepted DTI within 24 h of onset; fractional anisotropy (FA) and mean diffusivity (MD) of the bilateral cerebral peduncles were measured and converted to relative FA (rFA) and relative MD (rMD). Patients accepted minimally invasive puncture and drainage within 24 h of DTI. Motor function score (MFS) was used to evaluate the prognoses of limb motor function 90 d after puncture and drainage; and these patients were divided into good motor function outcome group (MFS scores of 0-3) and poor motor function outcome group (MFS scores of 4-8). The clinical data and DTI indexes were compared between the 2 groups; receiver operating characteristic (ROC) curve was used to analyze the efficacy of rFA in preoperative DTI in predicting limb motor function 90 d after puncture and drainage.Results:Fifty-four patients successfully completed minimally invasive puncture and drainage, without intracranial infection or obvious rebleeding. Twenty-two patients (40.7%) had good motor function outcome and 32 (59.3%) had poor one 90 d after puncture and drainage. No significant difference in age, gender, Glasgow coma scale score at admission, preoperative hematoma volume or postoperative residual hematoma volume was noted between the good function outcome group and poor function outcome group ( P>0.05). Compared with the good function outcome group, the poor function outcome group had statistically lower FA and rFA in the affected side of cerebral peduncles ( P<0.05). ROC curve showed that the area under the curve of preoperative rFA in predicting motor function 90 d after puncture and drainage was 0.984, with cutoff value of 0.78, sensitivity of 100%, and specificity of 96.9%. Conclusion:Preoperative DTI can effectively predict limb motor function 90 d after minimally invasive puncture and drainage in patients with moderate-volume hypertensive basal ganglia hemorrhage.
