SWI与ASL对超急性期脑梗死缺血半暗带显示和溶栓疗效的对比研究  

Comparative study between SWI and ASL in ischemic penumbra displaying and curative effect of thrombolysis of hyperacute cerebral infarction

作　　者：杜俊秋[1] 董万利[2] Du Junqiu;Dong Wanli(Department of Neurology,the Third People's Hospital of Huaian,Jiangsu 223001,China)

机构地区：[1]淮安市第三人民医院神经内科,江苏223001 [2]苏州大学附属第一医院神经内科

出　　处：《脑与神经疾病杂志》2018年第11期704-707,共4页Journal of Brain and Nervous Diseases

摘　　要：目的对比分析磁共振磁敏感加权成像(SWI)与动脉自旋标记成像(ASL)在超急性期脑梗死(ACI)缺血半暗带(IP)显示方面的应用价值。方法 30例超ACI患者,均行常规MRI平扫、DWI、SWI及ASL检查,通过观察SWI图像显示低密度血管影(MHV),并勾画测量其与DWI高信号不匹配区范围。通过观察脑血流量(CBF)伪彩图,勾画并测量脑梗死核心区周围低灌注与DWI高信号不匹配区范围。选取其中22例SWI与ASL均提示IP患者,对比分析两种成像方式对IP范围显示差异。并于溶栓前及溶栓后4w分别行NHISS评分,比较两组患者溶栓前后获益的程度。结果 SWI-DWI和ASL-DWI的不匹配范围较为一致,两种成像技术在显示IP面积对比差异无统计学意义(t=-2.961,P=0.07)。且按此分组的患者治疗后其NHISS评分改善程度无显著差异(t=1.625,P=0.112)。结论 SWI与ASL结合DWI序列,均能够较客观评估IP范围,为临床进行精准治疗提供客观依据。Objective To compare and analyze the application value of magnetic susceptibility-weighted imaging(SWI)and arterial spin labeling imaging(ASL)on ischemic penumbra(IP)displaying of hyperacute cerebral infarction.Method Conventional MRI scan,DWI,SWI and ASL of 30 patients with hyperacute cerebral infarction were examined.The mismatch ranges of low-density blood vessel shadow and high signal of DWI were sketched and measured by observing low-density blood vessel shadow shown in SWI image.Similarly,the mismatch ranges of low perfusion around the core of cerebral infarction and high signal of DWI were sketched and measured by observing the pseudocolor images of cerebral blood flow(CBF).22 cases of IP patients suggested by both SWI and ASL were selected.The difference was compared and analyzed on the two imaging modes showing the range of IP.NHISS scores were performed before thrombolysis and four weeks after thrombolysis,respectively.The degree of benefit before and after thrombolysis was compared between the two groups.Results The mismatch ranges of SWI-DWI and ASL-DWI were consistent and there was no statistical significance on the difference compared between the two imaging techniques showing the area of IP(t=-2.961,P=0.07).Furthermore,there was no significant difference in NHISS scores between the two groups before and after the treatment(t=1.625,P=0.112).Conclusion Combining the DWI sequence of SWI and ASL can both evaluate the IP range objectively,which provides an objective basis for clinical accurate treatment.

关 键 词：磁敏感加权成像 动脉自旋标记成像 缺血半暗带 

分 类 号：R743.32[医药卫生—神经病学与精神病学]