功能磁共振对重症脑梗死血流动力学状态的评价(附10例报告)  

The evaluation of the severe cerebral infarction hemodynamics by functional magnetic resonance imaging

作　　者：楼小琳[1] 马晓海[1] 钱怡宁 张茁[1] 毕齐[1] 

机构地区：[1]首都医科大学附属北京安贞医院神经内科,100029

出　　处：《北京医学》2006年第6期321-324,共4页Beijing Medical Journal

摘　　要：目的利用功能磁共振评价急性重症缺血性脑血管病患者的脑血流动力学状态。方法选择10例首次发病的急性重症脑梗死患者,于发病4d内行灌注加权成像(PWI)、扩散加权成像(DWI)、磁共振动脉造影(MRA)及MRI检查,同时行NIHSS评分及Glasgow昏迷评分,出院时再行NIHSS评分。分析功能磁共振检查结果。结果重症脑梗死缺血区内局部脑血流量(rCBF)、局部脑血容量(rCBV)均显著低于对侧脑组织,分别降低64.1%和49.7%,两侧比较均有显著性差异(P<0.01和P<0.05)。健侧脑组织也处于相对缺血状态,与同侧小脑组织比较,平均rCBF减少41.4%,rCBV减少33.0%。患侧平均通过时间图(rMTT)与对侧比较平均延迟3.1s,最严重者rMTT=0,而比较两侧对比达峰时间图(TTP)则无显著性差异。结论功能磁共振可为测量脑血流动力学指标提供一种量化的方法,尤其对于重症脑缺血患者,它可以快速、准确、无创地评价其脑血流动力学状态,是临床治疗和评价预后的较客观指标。Objective To evaluate the cerebral hemodynamics of the patients with acute severe ischemic cerebrovascular disease using MRI. Methods 10 cases were studied. All patients were acute cerebral infarction for the first time. The PWI, DWI, MRA and MRI examination were taken and the NIHSS and Glasgow mark were also measured at the same time with in 4 days after the attack. The NIHSS score were measured when the patients were discharged and/or when the patients died. A stroketool （v1.6） software package was used to analyse the functional MRI results. Results Regional cerebral blood flow （rCBF） and regional blood volume （rCBV） in the severe cerebral infarction ischemic region were significantly lower than the contra-lateral brain tissue. They could be reduced to 64.1% and 49.7% respectively. The difference between the two sideed of the brain was significant （P〈0.01 and P〈0.05 respectively）. The result showed that the uninjured brain tissue was also at relative ischemic state and its average rCBF and rCBV reduce to 41.4 % and 33.0% respectively. This study also showed that the average rMTT in the infarct side delayed for 3.1s in contrasts to the contra-lateral side and in the most severe case could reach rMTT=0. However, the TIP in the two sides had no significant difference. Conclusions The functional MRI evaluation is a kind of quantitative measurenment for the cerebral hemodynamic parameters. Ih can be used to evaluate the cerebral hemodynamics condition quickly, exactly and without damage and is especially suitable to those severe cerebral ischemia cases. It is an objective measurement for clinical therapy and prognostic evaluation.

关 键 词：功能磁共振成像 脑梗死 重症 

分 类 号：R743.3[医药卫生—神经病学与精神病学]