相对脑血流量和微出血与脑白质疏松分级关系的ASL及SWI研究  

Relationship Study in Relative Cerebral Blood Flow and Micro Bleeding and Grding Leukoaraiosis of ASL and SWI

作　　者：张丽丽[1] 高明勇[1] 杨冠英[1] 张仙海[1] 洪居陆[1] 卢瑞梁[1] 申小明[1] 赵海[1] 梁雪梅[1] 黄淑英[1] 梁栋梁[1] 

机构地区：[1]广东省佛山市第一人民医院影像科,528000

出　　处：《临床放射学杂志》2015年第6期880-884,共5页Journal of Clinical Radiology

基　　金：2014年佛山市医学类科技攻关项目(编号:2014AB00296)

摘　　要：目的探讨脑白质疏松（LA）的相对脑血流量（rCBF）与LA严重程度的关系及脑微出血（CMBs）与LA分级的相关性。方法搜集经MRI检查发现的LA患者30例（男10例,女20例,年龄51-87岁,平均68.7岁）和无脑白质异常者15例（男9例,女6例,年龄55-78岁,平均63岁）纳为研究对象,采用动脉自旋标记（ASL）技术测出半卵圆中心、侧脑室前角、侧脑室后角病灶及病灶周围正常白质的rCBF值,LA严重程度分为0-3级,分析rCBF值与严重程度分级的关系。采用SWI检测LA患者CMBs的情况,依据CMBs数量分为0-3级,分析LA分级与CMBs分级的相关性,并分别采用配对t检验、Wilcoxon秩和检验和Kruskal-wallis H检验。结果半卵圆中心、侧脑室前角、侧脑室后角病灶区较灶周正常白质的rCBF值明显减低,并且随着LA分级的加重,病灶区rCBF值逐渐减低,两者存在一定相关性（rs=-0.82、-0.75、-0.79,P=0.00）;LA分级与CMBs分级存在一定相关性（rs=0.532,P=0.00）。结论 ASL联合SWI技术可发现LA患者微小动静脉变化。随着LA分级的加重,病灶区rCBF值逐渐减低;LA与CMBs分级呈正相关。Objective To study relationship between r CBF values of LA and the severity of LA and correlating with LA and CMBs grading. Methods Objects in study collected from February 2013 to July 2014 in our hospital,including 30 cases of LA（ 10 males and 20 females,aged 51- 87 years,mean age 68. 7 years） and 15 cases without abnormal white matter（ 9 males and 6 females,aged 55- 78 years,mean age 63 years）. Using arterial spin labeling（ ASL） to measure r CBF values of centrum ovale、anterior corner lateral ventricle、posterior corner lateral ventricle lesions and surroundings normal white matter lesions,The severity of LA divide into 0- 3 grades,Analyze the relationship between r CBF values and severity grade; Using SWI to detect CMBs in LA patients,according to the number of CMBs divide to 0- 3 grades on SWI map,analyze the correlating with LA and CMBs grading. Apply paired t test,Wilcoxon rank sum test and Kruskal wallis H test of statistical methods. Results r CBF values of centrum ovale、anterior corner lateral ventricle、posterior corner lateral ventricle lesions and lesions around the NAWM are significantly reduced,with severity LA grading,r CBF values of lesions gradually reduced,both have correlation（ rs=- 0. 82,- 0. 75,- 0. 79,P = 0. 00）; LA and CMBs grading have correlation（ rs= 0. 532,P = 0. 00）. Conclusion Application ASL and SWI technical found small arteriovenous changes in LA patient,with LA grade increased,lesions gradually reduced r CBF; LA and CMBs grading have positive correlation.

关 键 词：脑白质疏松 微出血灶 动脉自旋标记 磁敏感加权成像 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]