FLAIR技术推测急性缺血性卒中发作时间的临床研究  

The study on estimation of the onset time by fluid-attenuated inversion recovery in acute ischemic stroke

作　　者：杨俊峰[1] 李月春[1] 王宝军[1] 姜长春[1] 崇奕[1] 刘洪勇[1] 索志强[1] 

机构地区：[1]内蒙古包头市中心医院神经内科,包头014040

出　　处：《中国神经精神疾病杂志》2015年第12期728-733,共6页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的通过对已知发病时间急性缺血性脑卒中(acute ischemic stroke,AIS)患者的头颅影像学中液体衰减反转恢复(fluid-attenuated inversion-recovery,FLAIR)序列及相应感兴趣区(volume of interest,ROI)信号强度的分析,研究是否可推测未知发病时间的AIS首次症状发作时间,是否能对溶栓治疗有一定的指导作用。方法选择2011年1月到2012年12月包头中心医院神经内科住院的AIS患者,首次症状发生在12 h内,并行核磁共振成像(magnetic resonance imaging,MRI)、磁共振弥散加权成像(diffusion-weighted imaging,DWI)、表观弥散系数(apparent diffusion coefficient,ADC)、FLAIR检查,确诊为AIS的47例符合入组条件的患者,分为≤180min、>180 min≤360 min、>360 min≤720 min三组,测量每一例患者病灶的DWI、FLAIR、ADC及对侧r DWI、r FLAIR、r ADC相应感兴趣区(region of interest,ROI)信号强度值,两两比较三组的FLAIR信号强度,并计算FLAIR阳性组、FLAIR阴性组的比率,进行统计学分析。结果三组病例的FLAIR信号强度值两两比较P=0.038,存在显著性差异;"≤180 min"和">180 min≤360 min"的FLAIR值均显著低于">360 min≤720 min";≤180min FLAIR阳性率16.7%,>180 min≤360 min阳性率62.5%,>360 min≤720 min阳性率70.6%。结论本研究共入组47例患者,其中≤180 min 6例、>180 min≤360 min 24例、>360 min≤720 min 17例;随着发病时间延长,FLAIR的阳性率逐渐增高;反之,FLAIR阳性率越低表明AIS发病时间越短,对急性期静脉溶栓治疗具有重要的指导作用。Objective To explore whether fluid-attenuated inversion recovery can be used to estimate the onset time of acute ischemic stroke（ALS） based on the analysis of signal strength through the fluid-attenuated inversion-recovery（FLAIR）and volume of interest（ROI） in ALS patients with known time of onset.MethodForty-seven AIS patients who met the inclusion criteria were recruited from Baotou Central Hospital, Department of Neurology from January 2011 to December 2012. The patients had stroke onset within 12 hours and completed MRI scan including diffusion-weighted imaging DWI, apparent diffusion and coefficient ADC FLAIR. Based on MRI findings, patients were divided into, three groups： 0-180 min, 180-360 min and 360-720 min groups. Signal strength values of the DWI、FLAIR and ADC in ipsilateral and contralateral sides were measured.ResultThere was a significant difference in the FLAIR signal strength among these three groups.The FLAIR signal strength was significantly lower in 0-180 min and 180-360 min groups thanin 360-720 min. FLAIR positive rate was 16.7%, 62.5%, and 70.6% in 0-180 min, 180-360 min and 360-729 min groups, respectively.ConclusionFLAIR positive rate gradually increases as the onset prolongs. Thus, lower FLAIR positive rate indicates shorter onset time of AIS, which can be used to assist acute intravenous thrombolytic therapy.

关 键 词：FLAIR 急性缺血性卒中 发作时间 

分 类 号：R743.3[医药卫生—神经病学与精神病学]