3D-ASL联合MRA在短暂性脑缺血发作中的应用价值研究  

Application Value of Three-Dimensional Arterial Spin Labeling Technique Combined with Magnetic Resonance Angiography in Transient Ischemic Attack

作　　者：于秀英[1] 何勇[1] 赵小燕[1] 韩广[1] 刘松国[1] YU Xiuying;HE Yong;ZHAO Xiaoyan;HAN Guang;LIU Songguo(Department of Radiology,Linyi Hospital of Traditional Chinese Medicine,Linyi Shandong 276002,China)

机构地区：[1]临沂市中医医院放射科,山东临沂276002

出　　处：《中国医疗设备》2020年第3期77-79,共3页China Medical Devices

基　　金：山东医药卫生科技发展计划面上项目(2018WS390)。

摘　　要：目的探讨三维动脉自旋标记技术(Three-dimensional Arterial Spin Labeling,3D-ASL)联合磁共振血管成像(Magnetic Resonance Angiography,MRA)在短暂性脑缺血发作(Transient Ischemic Attack,TIA)诊断中的临床应用价值。方法选取本院就诊的TIA患者36例,入选者均行常规MR检查、DWI、MRA及3D-ASL检查。由2名医生重建图像并定量测量脑血流量(Cerebral Blood Flow,CBF)。结果TIA患者3D-ASL示患侧灌注减低者明显多于健侧,差异有统计学意义(P<0.05)。TIA患者MRA示患侧平均CBF值(25.0±9.6)mL/(100g·min)低于健侧(44.0±13.5)mL/(100g·min),差异有统计学意义(P<0.05)。3D-ASL显示患侧灌注减低的患者27例(75.0%);MRA显示血管狭窄的患者16例(44.0%);两者联合应用显示异常的患者29例(80.0%)。3D-ASL和MRA联合检查的诊断正确率高于单独使用3D-ASL或MRA检查。结论3D-ASL技术可以发现TIA患者常规MR检查中无法发现的早期血流灌注异常,与MRA联合应用,可提高对TIA的诊断正确率。Objective To investigate the clinical value of three-dimensional arterial spin labeling(3D-ASL)combined with magnetic resonance angiography(MRA)in the diagnosis of transient ischemic attack(TIA).Methods Thirty-six patients with TIA who were admitted to our hospital were enrolled.All patients underwent routine MR examination,DWI,MRA and 3D-ASL examination.Two doctors reconstructed images and quantitatively analyzed cerebral blood flow(CBF).Results The 3D-ASL of TIA patients showed that the patients with hypoperfusion on the affected side were significantly more than those on the healthy side,and the difference was statistically significant(P<0.05).The mean CBF of the affected side of TIA patients[(25.0±9.6)mL/(100g·min)]was statistically lower(P<0.05)than that of the healthy side[(44.0±13.5)mL/(100g·min)].3D-ASL showed that 27 patients(75.0%)with reduced perfusion of the affected side.MRA showed that there were 16 patients(44.0%)with vascular stenosis.The combined application of 3D-ASL and MRA showed that there were 29 cases(80.0%)with abnormality.The diagnostic accuracy of the joint examination was higher than the 3D-ASL examination or the MRA examination.Conclusion 3D-ASL technology can detect early blood perfusion abnormalities that cannot be found in routine MR examination in TIA patients.Combined with MRA,it can improve the diagnostic accuracy of TIA.

关 键 词：三维动脉自旋标记 磁共振血管成像 短暂性脑缺血发作 脑血流量 

分 类 号：R445.2[医药卫生—影像医学与核医学] R814.43[医药卫生—诊断学]