3D-ASL与DSC-PWI在缺血性脑梗死患者中的对比研究  

Comparison study of three-dimension arterial spin labelling imaging (3D-ASL) and bolus contrast perfusion weighted imaging (DSC-PWI) in ischemic stroke patients

作　　者：张水霞[1] 张顺[1] 姚义好[1] 石晶晶[1] 王承缘[1] 朱文珍[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030

出　　处：《放射学实践》2014年第8期901-905,共5页Radiologic Practice

基　　金：国家自然科学基金(81171308);国家十二五科技支撑计划项目(2011BAI08B10)

摘　　要：目的:对比分析磁共振三维动脉自旋标记成像(3D-ASL)与动态磁敏感对比增强灌注成像(DSC-PWI)在缺血性脑梗死患者中的临床应用价值。方法:32例缺血性脑梗死患者行常规MRI序列、DWI、MRA、3D-ASL及DSC-PWI检查。观察脑梗死患者的3D-ASL、DSC-PWI灌注后处理图像并进行评分(显示有低灌注记为-1,未见明显灌注异常记为0,高灌注记为+1),并比较分析ASL-CBF与PWI测量的CBF、CBV、MTT及TTP之间的差异。结果:32例中ASL显示灌注异常者有28(87.5%)例,PWI-CBF、PWI-CBV、PWI-MTT及PWI-TTP异常者分别为18(56.25%)、18(56.25%)、19(59.38%)和21(65.63%)例。McNemar检验结果显示,ASL与PWI各参量图像所显示的灌注异常概率之间差异有统计学意义(P值分别为0.002、0.002、0.004和0.016);除去在任意一种灌注图像上显示为高灌注的病例后,ASL-CBF与PWI各参量比较的P值分别为0.008、0.008、0.063和0.125,其中MTT及TTP的差异无统计学意义。结论:作为一种无创性MRI技术,ASL在临床应用中能够较为真实可靠地反映缺血性脑梗死的低灌注状态。Objective：To compare the clinical value of three-dimension arterial spin labeling imaging （3D-ASL） and bolus contrast perfusion weighted imaging （DSC-PWI） in ischemic stroke patients. Methods： Routine MRI with DWI, MRA,3D-ASL and DSC-PWI scan were performed in 32 patients with ischemic stroke. The post-processed images of 3D ASL and DSC-PWI were studied and evaluating points were scored. Of which,hypoperfusion was recorded as -1 ,with no visible lesion as 0 and hyperperfusion as ＋ 1, the differences between ASL-CBF and CBF, CBV, MTT, TTP measured on PWI were compared. Results：Of the 32 patients,28 patients （87.5%） showed abnormalities on 3D-ASL,and 18 （56.25%）, 18 （56.25%）,19 （59.38%） and 21 （65.63%） patients were abnormal in PWI-CBF,PWI-CBV,PWI-MTT and PWI-TTP, respectively. The McNemar test analysis showed that there were statistical differences between ASL and DSC-PWI maps （CBF,CBV, MTT,TTP） in evaluating perfusion abnormalities caused by isehemic stroke （P value were 0. 002,0. 002, 0. 004,0. 016 respectively）. When hyperperfusion cases showed on any of the perfusion images were removed, there were stastic differences between ASL-CBF and PWI parameters （P： 0. 008,0. 008,0. 063 and 0. 125, respectively）, no statistical difference between ASL and PWI-MTT, PWI-TTP maps was existed. Conclusion： As a noninvasive technique, ASL has clinic use in detecting cerebral hypoperfusion in patients with ischemic stroke.

关 键 词：缺血性脑梗死 脑卒中 三维动脉自旋标记成像 动态磁敏感对比增强 灌注加权成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]