多延迟3D pCASL与CT灌注成像对烟雾病灌注评估的对比研究  

Comparsion study of multi-delay 3D pCASL and CT perfusion imaging on the assessment of moyamoya disease perfusion

作　　者：李彩霞[1] 陈曌[1] 许乙凯[1] 王刚[2] LI Caixia;CHEN Zhao;XU Yikai;WANG Gang(Imaging Center, Nanfang Hospital, Southern Medical University,Guangzhou 510515,China;Department of Neurosurgery , Nanfang Hospital, Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院影像中心,广东广州510515 [2]南方医科大学南方医院神经外科,广东广州510515

出　　处：《实用放射学杂志》2019年第8期1319-1323,共5页Journal of Practical Radiology

摘　　要：目的对比分析MR多延迟三维伪连续动脉自旋标记(3D pCASL)成像与CTP在烟雾病(MMD)中的临床应用价值。方法选取29例经DSA证实的MMD患者进行头颅CTP和多延迟3D pCASL成像。其中标记延迟时间(PLD)分别设为1 500 ms、1 800 ms、2 500 ms。勾画双侧大脑前、中、后及基底节的供血区,分别测得不同PLD 3D pCASL的脑血流量(CBF),CTP的脑血容量(CBV)、CBF、平均通过时间(MTT)、达峰时间(TTP)。采用K-S统计和Pearson相关性分析3D pCASL的CBF与CTP各参数之间的相关性。根据DSA,将所有患者的血管分为病变组和正常组,分析病变组3D pCASL的CBF与CTP各参数之间的相关性。结果(1)3D pCASL 3个不同PLD的CBF值有显著差异;(2)当PLD为1 500 ms、1 800 ms、2 500 ms时,3D pCASL的CBF分别与CTP的CBF、MTT、TTP有显著相关性(P<0.01),与CTP的CBV无相关性(P值分别为0.255、0.569、0.088)。(3)在病变组中,3D pCASL的CBF与CTP的CBF、MMT、TTP有显著的相关性(P<0.05),与CTP的CBV无相关性(P值分别为0.419、0.639、0.190)。结论在MMD脑灌注的评估中,多延迟3D pCASL的CBF与CTP的CBF、MMT、TTP有显著相关性,尤其是病变部位,多延迟3D pCASL的CBF也可作为脑血管储备(CVR)受损的指标。Objective To compare the clinical application value of MR multi-delay three-dimensional pseudo continuous arterial spin labeling (3D pCASL) imaging and CT perfusion (CTP) in moyamoya disease (MMD).Methods 29 patients with MMD confirmed by DSA were enrolled.All the patients underwent head CTP imaging and 3D pCASL acquisition with PLD of 1 500 ms, 1 800 ms,2 500 ms. Region of interests were draw on both side of the anterior, middle, posterior and basal ganglia cerebral artery territory.The cerebral blood flow (CBF) of the 3D pCASL with different PLD were calculated, as well as the CTP parameters:cerebral blood volume (CBV),CBF,mean transit time (MTT) and time to peak (TTP).K-S statistics and Pearson correlation coefficient test were used to compare the consistency between 3D pCASL-CBF and CTP parameters. According to DSA, all the patients were divided into lesion group and normal group,the consistency between 3D pASL-CBF and CTP parameters were analyzed in lesion group. Results (1)There were significant differences in 3D pCASL-CBF between different PLD.(2) When PLD was 1 500 ms, 1 800 ms and 2 500 ms, there were significant correlation between 3D pCASL-CBF and CTP-CBF,CTP-MTT,CTP-TTP (P<0.01).There were no correlation between 3D pCASL-CBF and CTP-CBV(P=0.255,0.569,0.088).(3)In the lesion group, there were significant correlation between 3D pCASL-CBF and CTP-CBF,CTP-MTT,CTP-TTP (P<0.005).There were no correlation between 3D pCASL-CBF and CTP-CBV(P=0.419,0.639,0.190).Conclusion For evaluation of cerebral perfusion in MMD, there are significant correlations between 3D pCASL-CBF and CTPCBF ,CTP-MTT, CTP-TTP, especially in the lesion areas.The multi-delay 3D pCASL-CBF also can be used as an index of impaired CVR.

关 键 词：烟雾病 三维伪连续动脉自旋标记 标记延迟时间 CT灌注成像 

分 类 号：R743[医药卫生—神经病学与精神病学] R814.43[医药卫生—临床医学]