三维动脉自旋标记成像联合DWI在急性脑缺血病变中的应用  

Application of Three Dimensional Arterial Spin Labeling Imaging Combined with Diffusion Weighted Imaging in Acute Cerebral Ischemic Disease

作　　者：庞坚信[1] 季文斌[1] 杨艳[1] 李杨飞[1] 王冬女[1] 樊树峰 PANG Jian-xin;JI Wen-bin;YANG Yan(Taizhou Hospital, Zhejiang 317000,China)

机构地区：[1]浙江省台州医院,317000 [2]浙江中医药大学附属第二医院,310005

出　　处：《心脑血管病防治》2019年第2期127-129,共3页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：浙江省医药卫生科技计划项目(编号:2010KYB123);浙江省台州市科技计划项目(编号:1701KY16)

摘　　要：目的探讨三维动脉自旋标记(3D-pc ASL)联合扩散加权成像(DWI)在急性脑缺血病变诊断中的应用价值。方法选取我院收治的60例急性脑血管病患者作为研究对象,给予常规MRI、DWI、液体衰减反转恢复序列(FLAIR)和3D-pc ASL序列检查;分别测量DWI高信号缺血区域与对侧镜像层面的脑血流量(CBF)值及表观扩散系数(ADC)值,进行对比分析,配对t检验比较两者间的差异。采用Pearson检验,分析CBF和ADC的相关性;绘制受试者工作特征(ROC)曲线,比较CBF及ADC两个参数对急性脑缺血病变的诊断效能。结果患侧区DWI信号增高,ADC值较镜像健侧降低,患侧平均ADC值为(0. 55±0. 12)×10^(-3)mm^2/s,镜像健侧区域平均ADC值为(0. 87±0. 16)×10^(-3)mm^2/s(P <0. 05);患侧区ASL灌注减低,CBF值较镜像健侧降低,患侧平均CBF值为(9. 96±13. 56) ml/100g·min,镜像健侧区域平均CBF值为(28. 80±18. 71) ml/100g·min,差异有统计学意义(P <0. 05)。CBF及ADC呈统计学正相关(r=0. 26,P <0. 05)。ROC曲线显示,联合CBF及ADC值两个参数对急性脑缺血病变的诊断效能最高(敏感度=98. 10%,特异度=85. 20%,曲线下面积=0. 98)。结论 3D-pc ASL联合DWI扫描有利于提高对急性脑缺血病变的诊断效能。Objective To reserch the value of three dimensional arterial spin labeling imaging( 3 D-pc ASL) combined with diffusion weighted imaging( DWI) in diagnosing acute cerebral ischemic disease. Methods 60 acute cerebral ischemic disease patients included in our hospital,accepted conventional MRI,DWI,fluid attenuated inversion recovery pulse sequence( FLAIR) and 3 D-pc ASL. Cerebral blood flow( CBF) and apparent diffusion coefficient( ADC) were measured and compared in high signal ischemic areas of DWI and mirror areas of the opposite side. Then Pearson test was used to analyze the correlation between CBF and ADC,and the ROC curve was drawn to compare the diagnostic efficacy of CBF and ADC in acute cerebral ischemia. Results DWI signal increased and ADC value decreased in the affected side compared to the mirror healthy side. The average ADC value of the affected side was( 0. 55 ± 0. 12)× 10^-3 mm^2/s,and the mirror healthy side was( 0. 87 ±0. 16)× 10^-3 mm^2/s,( P < 0. 05). The ASL perfusion of the affected side was decreased,the CBF value was lower than that of the mirror healthy side,and the average CBF value of the affected side was( 9. 96 + 13. 56) m L/100 g/min,mean CBF of mirror contralateral area was( 28. 80 + 18. 71) m L/100 g/min,( P < 0. 05),the difference was statistically significant. CBF and ADC were positively correlated( r = 0. 26,P < 0. 05). The ROC curve showed that the combination of CBF and ADC values had the highest diagnostic efficiency for acute cerebral ischemic diseases( sensitivity = 98. 10%,specificity = 85. 20%,area under curve = 0. 98). Conclusions 3 D-pc ASL combined with DWI scan can improve the diagnostic efficiency of acute cerebral ischemic disease.

关 键 词：三维动脉自旋标记 扩散加权成像 急性脑缺血病变 

分 类 号：R743[医药卫生—神经病学与精神病学]