ACZ负荷MR灌注成像对高血压患者脑血管储备功能的初步研究  

The Preliminary Study of Cebrovascular Reserve of Patients with Hypertension by Combining MR Perfusion-weighted Imaging with an Acetazolamide Challenge

作　　者：黄力[1] 高伟[1] 黄立安[2] 凌雪英[1] 

机构地区：[1]暨南大学附属第一医院医学影像中心,广州510630 [2]暨南大学附属第一医院神经内科,广州510630

出　　处：《临床放射学杂志》2008年第6期731-734,共4页Journal of Clinical Radiology

基　　金：广东省自然科学基金项目(编号:021154)

摘　　要：目的探讨MR灌注成像结合乙酰唑胺（ACZ）负荷试验，评估出现症状性脑梗死前高血压患者的脑血管储备功能。资料与方法对13例高血压患者和12例正常对照在口服ACZ前后进行2次MRPWI检查，选取双侧尾状核头部、豆状核、丘脑、额上回、颞上回及楔叶作为兴趣区（ROI），测量其局部脑血容量（rCBV）、平均通过时间（rMTT）并根据公式局部脑血流量（rCBF）=rCBV／rMTT、脑血管储备（％）=[（ACZ后rCBF-ACZ前rCBF）／ACZ前rCBF]×100％计算脑血管储备。结果（1）高血压组各ROI的rMTT、rCBV和rCBF在ACZ负荷前后无统计学意义（P〉0．05）；对照组各ROI的rMTT在ACZ负荷后缩短（P〈0．05），rCBV和rCBF在ACZ后增加（P〈0．05）；（2）高血压组各ROI的脑血管储备（5．5％～27．8％）较对照组相应ROI的脑血管储备（34．0％～56．1％）明显降低（P〈0．05）。结论在出现症状性脑梗死之前，高血压患者的脑血管储备较同年龄组正常血压者下降，处于亚临床缺血的状态。Objective To evaluate the cerebrovascular reserve （CVR） of patients with hypertension before symptom stroke infarction happens by MR perfusion-weighted imaging （PWI） with an acetazolamide challenge. Materials and Methods A pair of MR PWI were performed before and after oral administration of acetazolamide on 13 patients with hypertension and 12 controls. The regions of intrest（ROI） were selected on bilateral caput nuclei caudate, lenticular,thalamus, super frontal gyrus, super tempo gyrus, and cuneus symmetrically. The region cerebral blood volume （rCBV） and region mean transit time（rMTr） of ROIs were measured. The region cerebral blood flow（rCBF） and CVR was calculated by the formula：rCBF = rCBV/rMTT, CVR （ % ） = [ （ acetazolamide challenge rCBF-resting rCBF）/resting rCBF ] × 100%. Resuits （ 1 ） No significant differences of rMTT, rCBV and rCBF were observed in patients with hypertension before and after ACZ challenge. The rMTT was decreased and rCBV, rCBF were increased in controls after ACZ administration. （2） The CVR of patients with hypertension was decreased compared to the controls. Conclusion In patients with hypertension,the CVR has begun to decrease before symptom stroke infarction happens.

关 键 词：磁共振灌注成像 乙酰唑胺 脑血管储备功能 高血压 

分 类 号：R544.1[医药卫生—心血管疾病] R445.2[医药卫生—内科学]