非强化表观弥散系数值对急性脑梗死预后的研究  

Prediction of prognosis of infarct by analyzing apparent diffusion coefficient measurements in acute ischemic stroke without intravenous contrast material

作　　者：张立涛[1] 崔群生[1] 马振波[1] 武玉恒[1] 孔庆奎[1] 程琮[2] 

机构地区：[1]泰山医学院附属泰山医院影像诊断科,山东泰安271000 [2]泰山医学院公共卫生学院,山东泰安271016

出　　处：《泰山医学院学报》2011年第7期481-484,共4页Journal of Taishan Medical College

摘　　要：目的研究非强化表观弥散系数(ADC)值对急性脑梗死预后的诊断价值。方法筛选33例经MR证实的突发急性脑梗死患者作为研究对像。发病6～12小时及间隔4天分别行MR检查,然后在DWI上计算出梗死灶的大小。根据梗死灶的大小有无扩大,将患者分为两组:梗死灶扩大组(组I,n=22)与无扩大组(组II,n=11)。随后在两组患者的ADC图上分别取3个点:梗死灶中心、半暗带和对侧相应部位正常脑实质,将测得病灶大小及ADC值进行统计学分析。结果发病6～12小时与间隔4天,DWI上病灶大小有显著统计学差异(P<0.001),梗死灶中心与半暗带ADC均值无统计学差异(P>0.05),两组半暗带ADC均值有显著统计学差异(P<0.001)。结论梗死灶中心及半暗带的非强化ADC值对急性脑梗死预后评估及制定临床治疗方案是有帮助的。Objective： To investigate whether quantitative apparent diffusion coefficient（ADC） measurements can be employed to predict the prognosis of infarction in acute ischemic stroke without intravenous contrast material.Methods： Thirty-three patients having acute stroke symptoms with verified infarction in magnetic resonance imaging（MRI） were included in this study.Their MRI studies were performed between 6 and 12 h after the onset of their symptoms and were repeated.The infarction volumes were calculated by using DWI and the patients were divided into two groups as the ones having an expansion in the infarction area（group I,n=22） and the others having no expansion in the infarction area（group II,n=11）.The groups were compared in terms of the ADC values and areas obtained from DWI,referring to three points： the core of the infarction,ischemic penumbra and the contralateral nonischemic parenchymal tissue.Quantitative ADC values and the infarction area were estimated.P 0.05 were accepted to be statistically significant.Results： The internal mean infarction area during the times between 6 and 12 h and in the fourth day was calculated by DWI.A significant statistical result was demonstrated on the DWI between the two groups（P0.001） and there was no difference between the core of the infarction and parenchymal tissue（P0.05）.The ADC values of ischemic penumbra between the groups were found to be highly significant（P0.001）.Conclusion： We believe that ADC results obtained from the core and the penumbra of the infarction area without intravenous contrast material will be a feasible and practical in the estimation of the infarction prognosis and in the planning of a treatment protocol.

关 键 词：脑梗死 弥散加权成像 表现弥散系数 

分 类 号：R743.3[医药卫生—神经病学与精神病学]