磁共振脑灌注成像在颈动脉狭窄致短暂性脑缺血发作患者的预后应用价值  

Value of Magnetic Resonance Perfusion Imaging inEvaluating the Prognosis of Patients with Transient Ischemic Attack Caused by Carotid Artery Stenosis

作　　者：钟凯[1] 黎本丰 俸跃波 罗林[1] 周强 ZHONG Kai;LI Ben-feng;FENG Yue-bo;LUO Lin;ZHOU Qiang(The People＇s Hospital of Jianyang,Sichuan,Jianyang,641400,China)

机构地区：[1]四川简阳市人民医院,简阳641400

出　　处：《血栓与止血学》2018年第5期730-733,共4页Chinese Journal of Thrombosis and Hemostasis

摘　　要：目的研究磁共振脑灌注成像(MRPI)在颈动脉狭窄致短暂性脑缺血发作(TIA)患者的预后评估中的应用价值。方法收集我院2014年10月至2017年10月73例颈动脉狭窄致TIA患者的病历资料,均在我院行数字减影血管造影(DSA)与MRPI检查。所有患者入院后接受TIA规范治疗,进行为期3个月随访,根据随访结果将患者进行分组,脑梗死患者纳入脑梗死组,未发生脑梗死患者纳入无脑梗死组。结果 73例TIA患者共14例患者进展为脑梗死,发生率为19.2%。脑梗死组相对脑血容量(rCBV)、相对脑血流量(r CBF)显著低于无脑梗死组(P<0.05),相对平均通过时间(r MTT)、达峰时间(TTP)与无脑梗死组比较差异无统计学意义(P>0.05)。根据ROC曲线分析,rCBV与rCBF预测TIA患者脑梗死的曲线下面积分别为0.793、0.850,最佳阈值为1.010、1.195,灵敏度为79.7%、62.7%,特异度为71.4%、100.0%。结论 MRPI对TIA患者预后评价具有一定价值,通过rCBV、rCBF等脑灌注参数可以预测其脑梗死风险。Objective To study the value of magnetic resonance perfusion imaging（MRPI） in assessing the prognosis of patients with transient ischemic attack（TIA） caused by carotid artery stenosis.Methods The clinical data of 73 patients with transient ischemic attack caused by carotid artery stenosis who were admitted to the hospital from October 2014 to October 2017 were collected.All patients underwent digital subtraction angiography（DSA） and MRPI examination in the hospital.They were given standardized treatment for transient ischemic attack after admission and were followed up for 3 months.Patients were grouped according to the follow-up results.Patients with cerebral infarction were included in the cerebral infarction group and those without were included in the non cerebral infarction group.Results A total of 14 patients developed into cerebral infarction in 73 patients with transient ischemic attack,and the incidence was 19.2%.The relative cerebral blood volume（r CBV） and relative cerebral blood flow（r CBF） in the cerebral infarction group were significantly lower than those in the non-cerebral infarction group（P〈0.05）,but there was no significant difference in the relative mean transit time（r MTT） or time to peak（TTP） between the two groups（P〈0.05）.ROC curve analysis showed that the areas under the curve of r CBV and r CBF for predicting cerebral infarction in patients with TIA were 0.793 and 0.850,respectively.The optimal thresholds were 1.010 and 1.195,the sensitivities were 79.7% and 62.7%,and the specificities were 71.4% and 100.0%,respectively.Conclusion MRPI is of certain value in evaluating the prognosis of patients with TIA.The cerebral perfusion parameters such as r CBV and r CBF can be used to predict the risk of cerebral infarction.

关 键 词：短暂性脑缺血发作 颈动脉狭窄 脑梗死 磁共振脑灌注成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]