3D ASL成像对轻型颅脑损伤评估价值分析  

Evaluation of 3D ASL imaging in mild traumatic brain injury

作　　者：谢秀海 汤光宇[1] 赵振国[2] 钱帮伟[2] 隋海晶[2] 杨柳青 杨文进[2] XIE Xiu-hai;TANG Guang-yu;ZHAO Zhen-guo;QIAN Bang-wei;SUI Hai-jing;YANG Liu-qing;YANG Wen-jing(Department of Radiology,Shanghai Tenth People＇s Hospital,Tongji University,Shanghai 200072,China;Shanghai Pudong New Area People＇s Hospital,Shanghai 201200,China)

机构地区：[1]同济大学附属第十人民医院放射科,上海200072 [2]上海市浦东新区人民医院,上海201200

出　　处：《中国临床医学影像杂志》2018年第10期689-691,695,共4页Journal of China Clinic Medical Imaging

基　　金：上海市浦东新区卫计委科研基金(PW2015A-11)

摘　　要：目的:探讨三维动脉自旋标记成像(3D ASL)技术对轻型颅脑损伤(Mild traumatic brain injury,mTBI)患者的诊断及预后价值。方法:35例CT检查阴性的mTBI患者与25例健康志愿者进行常规MRI及3D ASL扫描,脑创伤3月后对患者组进行RPQ评分作为预后评估指标。结果:35例mTBI患者中有17例发现局部脑血流量(r CBF)灌注减低区;13例脑震荡后综合征(PCS)阳性(RPQ评分>14分)。17例发现r CBF灌注减低区患者中有11例(64.70%)PCS阳性;18例未发现rCBF存在明显灌注减低区患者中仅有2例(11.11%)PCS阳性。mTBI患者中存在局部灌注减低区组发生阳性PCS的概率明显高于无明显局部低灌注区组(P<0.01)。结论:3D ASL可发现mTBI患者存在全脑或局部脑血流灌注减低,对及时发现和纠正脑微循环异常、改善患者预后具有重要意义。Objective： To evaluate the diagnostic and prognostic value of three-dimensional arterial spin labeling（3 D ASL）in patients with the mild traumatic brain injury（mTBI）. Methods： Thirty-five mTBI patients with negative CT and 25 healthy volunteers underwent conventional MRI and 3 D ASL examination. After 3 months of brain trauma, the RPQ score of the patients group was used as a prognostic indicator. Results： Of the 35 patients with mTBI, regional hypoperfusion was found in17 cases. Thirteen cases（RPQ score14） were positive for post concussion syndrome（PCS）. Of the 17 patients with rCBF local hypoperfusion, 11（64.70%） were positive for PCS, and 18 had no significant local hypoperfusion, and only 2（11.11%） were positive for PCS. In patients with mTBI, the probability of PCS in the local hypoperfusion group was significantly higher than that in the non local hypoperfusion group（P〈0.01）. Conclusion： 3 D ASL perfusion imaging can quantitatively detect the decrease of cerebral blood flow in patients with mTBI. It is of great significance to detect and correct the abnormal brain microcirculation and improve the prognosis of the patients.

关 键 词：颅脑损伤 脑震荡后综合征 磁共振成像 

分 类 号：R651.15[医药卫生—外科学] R445.2[医药卫生—临床医学]