TOF MRA结合3D-ASL在脑动脉狭窄及闭塞疾病中的诊断价值  

Diagnostic value of time-of-flight MRA combined with 3D-arterial spin labeling in cerebral artery stenosis and occlusive disease

作　　者：卜顺林[1] 白卓杰[1] 张雨涵[1] 曾德材 寇君伟 王国兰 BO Shun-lin;BAI Zhuo-jie;ZHANG Yu-han;ZENG De-cai;KOU Jun-wei;WANG Guo-lan(Department of Radiology,Nanjing Jiangbei People's Hospital Affiliated to Nantong University,Nanjing,Jiangsu 210048,China)

机构地区：[1]南通大学附属南京江北人民医院放射科

出　　处：《中国临床研究》2018年第12期1689-1691,共3页Chinese Journal of Clinical Research

基　　金：南京医学科技发展项目(QRX17096)

摘　　要：目的探讨时间飞跃法磁共振血管成像(TOF MRA)结合三维动脉自旋标记技术(3D-ASL)灌注信息综合评价脑动脉狭窄及闭塞中的诊断价值。方法回顾本院42例脑动脉狭窄及闭塞患者TOF MRA的血管形态,测量相对脑血流量(r CBF),对比TOF MRA与3D-ASL的诊断结果。结果大面积脑梗死的诊断TOF MRA与3D-ASL诊断一致率为100%;脑动脉狭窄及闭塞伴3D-ASL灌注异常者39例(93%),不伴3D-ASL灌注异常者3例(7%)。结论 3D-ASL可定量分析脑动脉狭窄及闭塞患者的脑组织血流灌注信息,对大面积脑梗死患者两者诊断准确率较一致,而对部分TOF MRA上脑动脉狭窄及闭塞患者,由于侧支循环代偿,可不伴有大面积脑梗死,不伴3D-ASL灌注异常,两者结合可更准确的评估脑血管疾病,对临床的治疗提供参考意见。Objective To investigate the time-of-flight (TOF)magnetic resonance angiography (MRA)combined with 3D-arterial spin labeling (3D-ASL)in cerebral artery stenosis and occlusion.Methods The vascular morphology of TOF MRA in 42patients with cerebral artery stenosis or occlusion was reviewed.Relative cerebral blood flow (rCBF)was measured and the diagnostic results of TOF MRA and 3D-ASL were compared.Results The coincidence rate of TOF.MRA and 3D-ASL in diagnosis of massive cerebral infarction was 100%.There were 39patients (93%)had cerebral artery stenosis or occlusion with 3D-ASL perfusion abnormality and 3patients (7%)without 3D-ASL perfusion abnormality. Conclusion 3D-ASL could analyze cerebral blood flow perfusion information in patients with cerebral artery stenosis and occlusion quantitatively.The diagnostic accuracy of TOF MRA and 3D-ASL is consistent in patients with massive cerebral infarction.For some patients with superior cerebral artery stenosis and occlusion in TOF MRA,because of collateral circulation compensation,there may be no large area cerebral infarction and without perfusion abnormality in 3D-ASL.The combination of TOF MRA and 3D-ASL could provide more accurate assessment of cerebrovascular diseases and provide guidance for clinical treatment.

关 键 词：磁共振血管成像 时间飞跃法 三维动脉自旋标记技术 脑动脉狭窄 脑动脉闭塞 相对脑血流量 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445[医药卫生—临床医学]