多模式磁共振灌注技术在急性缺血性脑梗死患者脑血流灌注状态诊断中的应用  

Application of multimodal magnetic resonance perfusion technique in acute ischemic stroke patients with blood perfusion in the diagnosis

作　　者：郝敬波[1] 鹿彩銮[2] 时宏娟[3] 杨荣礼[1] 徐凯[2] 董瑞国[3] 

机构地区：[1]徐州医学院附属医院老年科,江苏221002 [2]徐州医学院附属医院影像科,江苏221002 [3]徐州医学院附属医院神经内科,江苏221002

出　　处：《脑与神经疾病杂志》2015年第6期412-417,共6页Journal of Brain and Nervous Diseases

摘　　要：目的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)在急性缺血性脑梗死患者脑血流灌注状态诊断中的应用。方法 22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(显示有高灌注记为+1,未见明显灌注异常记为0,低灌注记为-1),并比较分析ASL-CBF与PWI测量的CBF、CBV、MTT及Tmax之间的差异。结果 22例中ASL显示灌注异常者有19例(86.3%),PWI-CBF、PWI-CBV、PWI-MTT及PWI-Tmax异常者分别为14例(63.6%)、12例(54.5%)、14例(63.6%)和16例(72.7%)。Mc Nemar检验结果显示,ASL与PWI-CBF、PWI-CBV参数图在显示患者灌注差异有统计学意义(P值分别为0.025、0.008);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0.125、0.031、0.125、0.250,其中CBF、MTT及Tmax的差异无统计学意义(P<0.05)。结论作为一种无创性MRI灌注技术,ASL在临床应用中基本上能够较可靠地反映缺血性脑梗死患者的低灌注状态。Objective To analyze the cerebral blood flow perfusion status diagnosis in ischemic stroke patients by three-dimension arterial spin labeling imaging （ 3D-ASL ） and dynamic susceptibility contrast enhanced perfusion（DSC-PWI ）.Methods Routine MRI with DWI, MRA,3D-ASL and DSC-PWI scan were performed in 22 patients with ischemic stroke.Observation of patients with cerebral infarction 3DA-SL and DSC-PWI perfusion image processing and score （ showed hyperperfusion is denoted by ＋1, no vision recorded as 0, hypoperfusion denoted as-1） , and a comparative analysis of the differences between ASL -CBF and PWI in measurement of CBF,CBV, MTT andTmax.Results 22patientsofASLperfusionabnormalin19cases（86.3%）,PWI-CBF,PWI-CBV,andPWI-Tmax PWI-MTT abnormal respectively for 14 patients （63.6%）, 12 patients （54.5%）, 14 patients （63.6%） and 16 patients （72.7%）.The MC nemar test results showed that ASL and PWI-CBF, PWI-CBV parameters in patients showed perfusion differences had statistical significance （P=0.025, 0.008, respectively）.Remove display cases of hypererfusion, ASL-CBF and PWI parameters P were 0.125 ,0.031, 0.125, 0.250, where differences in CBF, MTT and Tmax no statistical significance （ P〈0.05） .Con clusion As a noninvasive technique, ASL can basically in clinical application is reliable to reflect the hypoperfusion in patients with ischemic cerebral infarction.

关 键 词：缺血性脑梗死 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：R743.32[医药卫生—神经病学与精神病学]