Longitudinal follow-up study on diffusion tensor imaging in medulla infarct

ZHANG Miao; LU Jie; RONG Dongdong; ZHAO Zhilian; SHAN Yi; MA Qingfeng; LI Kuncheng

Abstract：Objective To explore the change of diffusion tensor characteristics and the relationship between corticospinal tract injury and motor outcome after medulla infarction using diffusion tensor imaging(DTI). Methods We evaluated three patients with unilateral medulla infarct. The patients underment DTI three or five times during 1 month or 6 months after stroke onset. The relative fractional anisotropy (rFA) values were measured in the medulla, cerebral peduncle, and internal capsule, and neuro-functional scores were evaluated. The three-dimensional corticospinal tract was reconstructed using diffusion tensor tractography (DTT). The changes of the rFA values and the relationship between corticospinal tract injury and motor outcome were studied. Results Two patients showed good motor recovery,and the rFA values in the medulla,cerebral peduncle,and internal capsule were slightly decreased. DTTs demonstrated the corticospinal tract was not compressed and interrupted. The third patient had the most obvious decrease in rFA values,with serious motor function damage. The affected corticospinal tract passed through the in-farct and was disrupted. Conclusion The corticospinal tract injury and secondary retrograde degeneration were related with the movement function involvement and recovery in medulla infarct patients,which can provide important basis for evaluation of prog-nosis.