三维动脉自旋标记在急性脑梗死功能恢复评估中的应用  

The application of three-dimensional arterial spin labeling in the evaluation of neurological functional recovery in patients with acute schemic stroke

作　　者：黄晓琪 陈玲[1] 林阳洋 覃盛宝 崔惠勤[1] HUANG Xiaoqi;CHEN Ling;LIN Yangyang;QIN Shengbao;CUI Huiqin(Department of Imaging,the Fourth Affiliated Hospital of Guangxi Medical University,Liuzhou 545005,China)

机构地区：[1]广西医科大学第四附属医院医学影像科,广西柳州545005

出　　处：《实用放射学杂志》2020年第1期9-12,共4页Journal of Practical Radiology

基　　金：柳州市科学研究与技术开发计划课题基金项目(2016G020208);广西卫生和计划生育委员会自筹课题项目(Z2016188)。

摘　　要：目的 探讨基于三维动脉自旋标记(3D-ASL)技术的脑血流量(CBF)评估急性缺血性脑梗死(AIS)患者神经功能恢复的可行性.方法 回顾性分析 70 例 AIS患者治疗前后 3D-ASL图像以及美国国立卫生研究院卒中量表(NIHSS)评分,在 DWI图像上手动勾勒出 ROI,重叠在CBF图像上以获得CBF值,再取同层面对侧正常脑实质区域 CBF值作为对照,求其比值,得出相对脑血流量(rCBF),对治疗前后所得 CBF 值、rCBF 值以及临床 NIHSS 评分分别进行配对t 检验.结果 治疗前后所得梗死区域CBF、rCBF以及 NIHSS评分差异均有统计学意义(P<0.05).63 例患者治疗后梗死区域 CBF 值较治疗前上升,其中 62 例患者NIHSS评分下降,1 例上升;7 例患者治疗后梗死区域CBF值较治疗前降低,其中2 例临床NIHSS评分无变化,5 例NIHSS评分升高.结论 3D-ASL技术提供的灌注值可靠,可作为 AIS患者治疗后评估脑血流变化的常规检查序列.初步研究结果认为,多数脑灌注恢复的患者其神经功能恢复较好.Objective To assess the feasibility of three-dimensional arterial spin labeling(3D ASL)technique basing on cerebral blood flow(CBF)in predicting neurological recovery in patients with acute ischemic stroke(AIS).Methods The 3D-ASL image and National Institutes of Health Stroke Scale Score(NIHSS)of 70 patients with AIS before and after treatment were analyzed retrospectively.ROI was manually selected on DWI,the CBF at the infarct side and the contralateral side were measured by overlaying the DWI image,rCBF was formed by their ratio.This study took paired t tests for the values of CBF,rCBF and NIHSS before and after treatment respectively.Results There was significant difference in the changes of CBF,rCBF and NIHSS before and after treatment(P<0.05).The CBF of the infarct area turned higher in 63 patients after treatment,among them,NIHSS decreased in 62 patients but increased in 1 patient.The CBF of the infarct area turned lower in 7 patients after treatment,among them,NIHSS showed no change in 2 patients but increased in 5 patients.Conclusion The perfusion value basing on 3D ASL was proved to be reliable.3D ASL can be considered as a routine method for analyzing the cerebral hemodynamic changes and predicting neurological recovery in AIS patients after treatment.The preliminary results suggest that patients with cerebral perfusion recovery will have better neurological functional recovery.

关 键 词：脑血流量 急性脑梗死 神经功能恢复 三维动脉自旋标记 

分 类 号：R743.33[医药卫生—神经病学与精神病学]