动脉瘤破裂致脑血管痉挛的MR灌注评估  

MR perfusion assessment of cerebral vasospasm caused by aneurysm rupture

作　　者：杨红莉 YANG Hongli(Department of Special Inspection Section,Yima Coal Industry Limited Group General Hospital,Sanmenxia 472300,China)

机构地区：[1]义马煤业集团股份有限公司总医院特检科,河南三门峡472300

出　　处：《中国实用神经疾病杂志》2018年第8期880-883,共4页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨磁共振灌注成像(MR-PWI)在评估动脉瘤性蛛网膜下腔出血(aSAH)后脑血管痉挛脑血流动力学中的临床价值。方法选取2013-09—2016-10义马煤业集团股份有限公司总医院收治的80例aSAH患者为研究组,另选取同期颅内未破裂动脉瘤患者31例为对照组,均接受MR-PWI检查。结果研究组中无痉挛者20例,轻度痉挛者23例,中度痉挛者21例,重度痉挛者16例;重度痉挛组基底节区(BSGL)、大脑中动脉(MCA)供血区、大脑前动脉(ACA)供血区中rCBV、rCBF水平低于对照组,中度痉挛组、轻度痉挛组及无痉挛组ACA供血区rCBF、BSGL的rCBF水平低于对照组,中度痉挛组BSGL、MCA供血区、ACA供血区中MTT、TTP水平高于对照组,重度痉挛组BSGL、MCA供血区、ACA供血区中MTT、TTP水平高于中度痉挛组,差异有统计学意义(P<0.05)。结论 MR-PWI可有效评估蛛网膜下腔出血后脑血管痉挛脑血流动力学变化情况,可为制定干预方案提供依据。Objective To investigate the clinical value of magnetic resonance perfusion imaging(MR PWI)in evaluating posterior cerebral vasospasm cerebral hemodynamics in patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods Eighty cases of aSAH patients from September 2013 to August 2016 in our hospital were selected as the study group,and thirty one patients with unruptured intracranial aneurysms were selected as the control group,all the patients underwent MR PWI examination.Results There were 20 cases without spasm,23 cases with mild spasm,21 cases with moderate spasm,and 16 cases with severe spasm.In the group of severe spasm patients,the levels of rCBV and rCBF in the BSGL and MCA blood supply areas and ACA blood supply areas were lower than those of the control group;in the groups of patients with mild spasm,moderate spasm and without spasm,the levels of rCBF and BSGL in the ACA blood supply area of were lower than those of the control group;in the groups of patients with moderate spasm,the levels of MTT and TTP in BSGL and MCA blood supply areas and ACA blood supply areas were higher than those in control group.The levels of MTT and TTP in the BSGL and MCA blood supply areas and ACA blood supply areas in the severe spasm group were higher than those in the moderate spasm group(P<0.05).Conclusion MR PWI can effectively assess the cerebral vasospasm and hemodynamic changes after subarachnoid hemorrhage,and can provide guidance for the intervention program.

关 键 词：磁共振灌注成像 动脉瘤性蛛网膜下腔出血 脑血管痉挛 脑血流动力学 

分 类 号：R743.35[医药卫生—神经病学与精神病学]