磁共振3D-ASL与DWI在脑血管闭塞疾病中的临床应用价值  

Clinical application value of 3D-ASL and DWI in cerebrovascular occlusion diease

作　　者：纪宇[1,2] 邵广瑞[2] 马帅[2] 

机构地区：[1]山东大学,山东济南250012 [2]山东大学第二医院影像科,山东济南250033

出　　处：《医学影像学杂志》2016年第7期1164-1166,1169,共4页Journal of Medical Imaging

摘　　要：目的探讨三维动脉自旋标记(3D arterial spin labeling,3D-ASL)成像与磁共振弥散加权成像(diffusion weighted imaging,DWI)在脑血管闭塞疾病中的诊断价值。方法 30例患者均为磁共振血管成像(magnetic resnance angiography,MRA)显示一支或多支脑血管闭塞,其中脑梗死20例,短暂性脑缺血发作10例。所有患者均行MRA、T1WI、T2WI、DWI及3D-ASL扫描。分别测量ASL灌注异常面积和DWI信号异常面积,结果采用配对样本t检验分析。再根据ASL灌注异常面积与DWI信号异常面积将患者分为ASL>DWI组、ASL≈DWI组、ASL<DWI组,观察并分析患者ASL及DWI图像。结果 ASL灌注异常面积与DWI信号异常面积经配对t检验,差异有统计学意义(P<0.01)。30例脑血管闭塞患者中:ASL>DWI组中患者29例(29/30,96.7%),ASL≈DWI组中患者1例(1/30,3.3%),ASL<DWI组中患者0例(0/30,0%)。在脑梗死患者中:ASL>DWI组中患者19例(19/20,95%),ASL≈DWI组中患者1例(1/20,5%),ASL<DWI组中患者0例(0/20,0%)。在TIA患者中:均为ASL>DWI且DWI上无异常信号。结论 ASL在脑血管闭塞疾病的诊断中有重要的意义,结合DWI扫描,能够确定半暗带的范围ASL有利于TIA的早期诊断。Objective To explore value of 3D arterial spin labeling （3D-ASL） imaging and diffusion weighted imaging （DWI） in the diagnosis of cerebrovascular occlusion diease. Methods A total of 30 cases with cerebral infarction in 20 case and transient ischemic attack （TIA） in 10 case were included in this study. They were all one or more cerebral vascular occlusion in MRA. All subjects underwent T1WI, T2WI, DWI, 3D-ASL scanning. We respectively measured ASL perfusion abnormal area and DWI lesions. The results were analyzed by paired t-test. Then, all patients were classified into ASL 〉 DWI group, ASL DWI group and ASL 〈 DWI group according to abnormal area of ASL maps and DWI lesions. We observed and analyzed the ASL and DWI images of all patients. Results The paired samples test showed the results had statistical significance （ P 〈 0.05 ）. In 30 patients with cerebrovascular occlusion, there were 29 cases in ASL 〉 DWI group （29/30, 96.7% ）. There was 1 case in ASL ≈DWI group （1/30, 3.3% ）. There was no 0 case in ASL 〈 DWI group （0/30, 0% ）. In patients with cerebral infarction, there were 19 cases in ASL 〉 DWI group （19/20, 95% ）. There was 1 case in ASL≈DWI group （1/20, 5% ）. There was no 0 case in ASL 〈 DWI group （0/20, 0% ）. In patients with TIA, all for ASL 〉 DWI group and DWI had no abnormal signals on the images. Conclusion ASL had important values for the diagnosis of cerebrovascular occlusion diease, combined with DWI scan, ASL can confirm the scope of the penumbra; ASL had values for early diagnosis of TIA and patients.

关 键 词：三维动脉自旋标记 磁共振弥散成像 脑血管闭塞 脑血流灌注 

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