신경섬유 손상에 따른 급성기 뇌출혈 환자의 확산 텐서 이미지와 언어장애 특성

Characteristics of Diffusion Tensor Imaging and Language Dysfunction Based on Nerve Fiber Injury in Patients with Acute Hemorrhagic Stroke

Purpose: Diffusion tensor imaging (DTI) technique visualizes to localize and grade nerve injury in brain. Since aphasia is serious common problems in patients with stroke, the present study aimed to explore the features of language dysfunction across the various aphasia types based on nerve fiber injury using a novel DTI in patients with acute hemorrhagic stroke. Methods: One normal adult male and five adults with acute hemorrhagic stroke (patient group) within 30 days from symptom onset participated in this study. Brain CT, MRI, DTI images and Paradise Korean-Western Aphasia Battery-Revised (PK-WAB-R) were tested within 1 month after brain damage. Two dorsal nerve fibers [superior longitudinal fasciculus (SLF), arcuate fasciculus (AF)] and two ventral nerve fibers [inferior longitudinal fasciculus (ILF), uncinate fasciculus (UF)] were investigated using DTI analysis. Results: Hematoma volumes were relatively larger and Aphasia Quotient scores were lower in P1, P3, and P5. Location of lesion on CT and MRI was same with P1, P5, but the aphasia type by PK-WAB-R was different from each other. This finding showed that there was no absolute relationship between the lesion site and aphasia type but the relationship between the nerve fiber injury site on DTI and aphasia type. Non-fluent patients (P1, P3, P5) showed SLF, AF damage whereas relatively good comprehensive patients (P2, P4, P5) showed relative preservation of ventral nerve tract except in P5 who showed UF damage. Conclusion: DTI provided the sensitive detection of nerve fiber damage in patients with cerebral hemorrhage and useful tool in predicting aphasia type and language dysfunction.