Diffusion Tensor Magnetic Resonance Imaging as a Prognostic Indicator in the Deep Intracerebral Hemorrhage

Abstract

Objective：Diffusion tensor MR imaging (DTI) provides a means to visualize the course of the corticospinal tract within the white matter. The purpose of this study was to investigate the corticospinal tract in patients with deep intracerebral hemorrhage (ICH) involving the posterior limb of the internal capsule, to correlate with the motor impairment of the extremities, and to predict with motor improvement after stereotactic evacuation of the ICH. Methods : Ten patients with deep intracerebral hemorrhage (ICH) on the basal ganglia or thalamic region were included to this study. All patients underwent the stereotactic catheter insertion. The DTI was obtained within 5 days after the hemorrhagic attack, focusing on the posterior limb of the internal capsule (PIC). The patients were evaluated using the motor grading system (grade 0 to 5) initially and 2 months later. The Mann-Whitney U test was used for the statistical analysis. Results : The motor scales improved only in the patients with the partially or non-involved PIC. The p value was 0.007 for upper extremities and 0.008 for lower extremities. In patients with the totally preserved PIC, follow-up motor scales improved in comparison with the preoperative state. In patients with the partially preserved PIC, follow-up motor scales improved according to the hierarchical organization principles. Conclusion : The DTI can show the degree and locations of the involvement by the hemorrhages to PIC and the DTI may be used as a good indicator to the motor function outcome in the patients with hemorrhagic stroke at basal ganglia or thalamic region.