磁共振扩散峰度成像预测急性脑梗死预后的初步研究  

Preliminary research of DKI parameters in predicting the prognosis of brain acute stroke lesions

作　　者：陈芳 杨永贵[1] 郭岗[1] CHEN Fang;YANG Yong-gui;GUO Gang(Department of Radiology, Xiamen No.2 Hospital, Xiamen 361021, China)

机构地区：[1]厦门市第二医院放射影像科,厦门361021

出　　处：《磁共振成像》2018年第2期127-132,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：厦门市科技局科技计划项目(编号:3502Z20144050);厦门市重要重大疾病联合攻关项目(编号:3502Z20149032)~~

摘　　要：目的探讨磁共振扩散峰度成像(diffusion kurtosis imaging,DKI)相比于扩散加权成像(diffusion weighted imaging,DWI)及扩散张量成像(diffusion tensor imaging,DTI)在预测急性脑梗死预后的优势。材料与方法选取我院1例女性急性脑梗死患者,患者首次检查共发现9个急性脑梗死病灶,分别测量病灶的体积、表观扩散系数(apparent diffusion coefficient,ADC)及DKI各参数值。12 d后对该患者进行复查,发现9个病灶体积变化不同,将体积变小的4个病灶归为第1组,体积变大的5个病灶归为第2组。分析两组病灶首次检查的ADC值及DKI参数值的差异性,并且对9个不同病灶首次检查的ADC值及DKI参数值与两次检查病灶体积变化的相关性进行分析。结果 9个病灶首次检查的平均扩散峰度(mean kurtosis,MK)、轴向峰度(axial kurtosis,Ka)、径向峰度(radical kurtosis,Kr)、△MK及△Ka与病灶体积变化呈正相关,相关系数r分别为0.791、0.805、0.732、0.802及0.855,相关性强。两组病灶的△MK值差异有统计学意义(P<0.05),△ADC值及其他DKI参数值差异均无统计学意义(P>0.05)。结论研究表明,急性脑梗死病灶的DKI参数值(MK、Ka及Kr)高可能预示着病灶的预后较差,可为临床治疗及预后评估提供指导性意见。Objective： This paper aims to research the greater advantage of diffusion kurtosis imaging （DKI） in predicting the prognosis of the brain acute stroke than diffusion weighted imaging （DWI） and diffusion tensor imaging （DTI）. Materials and Methods： We chose a female patient who has 9 acute stroke lesions in brain. We measured the DWI, DKI parameters and volume of 9 lesions. We found that the prognosis of 9 lesions was diverse in the re-examination after 12 days. Four lesions which volume decreased were divided into group 1, and fve lesions which volume increased were divided into group 2. The difference of DWI and DKI parameters between two groups was assessed by independent-samples t test. The correlation between DWI, DKI parameters and volume change before and after treatment was assessed by Pearson correlation coefficients. Results： It shows that mean kurtosis （MK）, axial kurtosis （Ka）, radical kurtosis （Kr）, △MK and △Ka have strong correlation with the volume change before and after treatment, the correlation coeffcients are 0.791, 0.805, 0.732, 0.802 and 0.855. △MK is signifcant difference （P〈0.05） between two groups of lesions. △ADC and other DKI parameters are not signifcant difference （P〉0.05） between two groups. Conclusions： The result indicates that the larger of the DKI parameters （MK, Ka, Kr） may predict the worse prognosis. DKI may provide guidance to clinical treatment and assessment in brain acute stroke.

关 键 词：扩散峰度成像 卒中 扩散加权成像 扩散张量成像 磁共振成像 预后 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]