磁共振3D-pcASL成像技术在急性缺血性脑卒中的应用  

Application of 3D-pc ASL magnetic resonance imaging in the diagnosis of acute cerebral apoplexy

作　　者：毛传万[1] 付玉川[1] 毛翌婷 黄建河[1] 林旭波[1] 史建静[1] 周云新[1] 吴爱琴[1] 

机构地区：[1]温州医科大学附属第二医院放射科,浙江温州325027 [2]温州医科大学第一临床学院,浙江温州325035

出　　处：《温州医学院学报》2015年第5期350-353,共4页Journal of Wenzhou Medical College

摘　　要：目的:评价磁共振三维伪连续动脉自旋标记(3D-pc ASL)灌注成像在急性缺血性脑卒中的应用价值。方法:对39例临床拟诊缺血性脑卒中且发病时间在7 d内患者行常规磁共振弥散加权成像(DWI)及3Dpc ASL成像扫描。观察急性脑梗死病灶在3D-pc ASL与常规DWI影像中的表现,同时测量病灶及对侧镜像区域脑组织的脑血流量(CBF)值。结果:39例脑缺血患者经随诊证实脑梗死34例,TIA 5例。34例脑梗死患者中,21例病灶累及灰质区域,3D-pc ASL表现为低灌注,平均CBF值(16.7±12.2)m L·min-1·100 g-1,较对侧镜像区域脑组织的CBF值[(44.8±13.9)m L·min-1·100 g-1]低(P<0.01);另外13例病灶仅累及白质区域,病灶与白质对比不明显,故未测量CBF值。5例TIA患者中,3例ASL表现为低灌注,平均CBF值(37.6±4.4)m L·min-1·100 g-1,对侧CBF(58.8±10.6)m L·min-1·100 g-1。34例脑梗死患者DWI均表现高信号,3D-pc ASL检出21例(病变均累及灰质),其中17例患者ASL图像显示的病灶范围大于DWI。5例TIA患者DWI图像未见异常信号改变。结论:3D-pc ASL可以对累及灰质区域缺血性卒中的患者提供定位、定性、定量诊断,并能部分检出DWI表现阴性的TIA患者,但对白质区域缺血性病变存在较大的局限性。Objective： To assess the applied value of the three-dimensional pseudo-continuous arterial spin labeling（3D-pc ASL） technique in MRI Perfusion-weighted imaging in acute ischemic stroke. Methods： DWI and 3D-pc ASL technique were be performed in thirty-nine patients suspected ischemic stroke and the onset time for 7 days. The findings of the lesions in acute cerebral infarction patients on 3D-ASL images and conventional DW images were observed. Then, the CBF values of the lesions and the contralateral symmetrical brain regions were measured. Results： Among the 39 cases, 34 cases were diagnosed as cerebral infarction during follow-up, 5 cases with TIA. In the 21 of 34 patients with cerebral infarction, the lesions were located at the gray matter, and showed low perfusion on 3D-pc ASL images. The mean CBF values of these lesions were 16.7±12.2 m L·min^-1·100 g^-1, and were lower than that at the contralateral area 44.8±13.9 m L·min^-1·100 g^-1（P0.01）; In the other 13 cases, the lesions only involved in the white matter, the CBF values of these lesions weren＇t measured for their poor differentiation with the white matter on 3D-pc ASL images, in the 5 TIA patients, the lesions of 3 cases showed low perfusion on the 3D-ASL images. The mean CBF values of the affected regions were 37.6±4.4 m L·min^-1·100 g^-1, 58.8±10.6 m L·min^-1·100 g^-1 in the contralateral areas. In 34 cases of cerebral infarction patients, the lesions in DWI all showed high signal. However, the lesions were detected only in 21 cases on the 3D-ASL images, the area of the lesions on 3D-pc ASL images was larger than that on the DWI in 17 of 21 patients. The singal was normal on DWI in the 5 TIA patients. Conclusion： The 3D-pc ASL technique can provide localization, qualitative and quantitative diagnosis in ischemic stroke patients with the lesions located at gray matter. It can also discover that the TIA patients show normal on DWI. However, this technique has some limitations in the detection of ischemic lesions in the whi

关 键 词：缺血性卒中 脑梗死 磁共振成像 动脉血流标记成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]