MR三维动脉自旋标记灌注成像联合ABCD2评分在TIA发作早期发生脑梗死预测的价值  

The value of MR 3D ASL perfusion imaging with ABCD2 score in predicting the early onset of cerebral infarction post TIA

作　　者：李杰 李颖 吴立梅 田玉红 LI Jie;LI Ying;WU Li-mei(Department of MRI,Qinhuangdao Workers'Hospital,Qinhuangdao,066299,China)

机构地区：[1]秦皇岛市工人医院磁共振室,河北秦皇岛066200 [2]秦皇岛市工人医院神经内科,河北秦皇岛066200

出　　处：《中国医学装备》2020年第3期62-66,共5页China Medical Equipment

基　　金：河北省秦皇岛市科技计划自筹经费项目(201805A028)“MR三维动脉自旋标记成像在TIA发作诊断及早期发生脑梗死预测中的价值”。

摘　　要：目的:分析MR三维动脉自旋标记(3D ASL)灌注成像联合短暂性脑缺血发作(TIA)早期卒中风险预测ABCD2评分对TIA发病早期发生脑梗死的预测价值。方法:选取医院收治的45例临床确诊TIA住院患者,分别进行3D ASL灌注成像和ABCD2评分。根据ABCD2评分将45例患者分为低危组(11例)、中危组(13例)和高危组(21例);根据3D ASL有无低灌注病灶分ASL低灌注组(23例)及ASL正常灌注组(22例);按TIA患者7 d内是否进展判断为梗死及非梗死。分析3D ASL灌注检查结果、ABCD2评分及二者联合应用与TIA后7 d内发生脑梗死的关系。结果:在45例TIA患者中末次发病后7 d内发生脑梗死10例(占22.2%)。ABCD2评分低危组11例,7 d内无脑梗死发生;中危组13例,2例发生脑梗死(占15.4%);高危组21例,8例发生脑梗死(占34.8%);ABCD2评分与TIA后7 d内发生脑梗死呈正相关(r=0.46,P<0.05)。3D ASL脑灌注成像中,正常灌注组22例,其中1例7 d内发生了脑梗死(占4.5%),低灌注组23例中9例发生了脑梗死(占39.1%),正常灌注组脑梗死发生率明显低于低灌注组,差异有统计学意义(χ^2=7.782,P<0.05)。ABCD2评分低危+低灌注及正常灌注共11例,无脑梗死发生,ABCD2评分中高危+低灌注21例,9例发生脑梗死(占42.9%),ABCD2评分中高危+正常灌注13例,1例发生脑梗死(占7.7%)。ABCD2评分高危+低灌注16例,8例发生梗死(占50.0%),高危+正常灌注5例,0例梗死,两者比较差异有统计学意义(χ^2=11.084,P<0.05)。结论:3D ASL灌注成像联合ABCD2评分在预测TIA后早期发生脑梗死风险方面具有重要的临床价值。Objective: To analyze the predictive value of three-dimension arterial spin labeling imaging(3D ASL) combined with ABCD^2 score of risk prediction of early stroke of transient ischemic attack(TIA) on the cerebral infarction at the early stage post TIA. Methods: 45 patients with TIA who were confirmed by clinical examination were selected. And they underwent 3D ASL perfusion imaging and ABCD^2 scores respectively. According to the ABCD^2 score, 45 patients were divided into low-risk group(11 cases), middle-risk group(13 cases) and high-risk group(21 cases). According to the perfusion lesion of 3D ASL, they were divided into ASL hypoperfusion group(23 cases) and ASL normal perfusion group(22 cases). And infarction and non-infarction were judged according to whether infarction of patients with TIA progressed within 7 days. The relationships between the results of 3D ASL perfusion examination and cerebral infarction within 7 days post TIA, and between ABCD^2 score and that, and between the combined application of them and that were analyzed, respectively. Results: In 45 patients with TIA, 10 cases had infarction within 7 days after the last onset, and the incidence was 22.2%. As the ABCD^2 score, 11 patients were in low-risk group, and there was no cerebral infarction on them within 7 days. And 13 patients were in middle-risk group, and 2 patients of them had cerebral infarction(15.4%). And 21 patients were in high-risk group, 8 patients of them had cerebral infarction(34.8%). There was a positive correlation between ABCD^2 score and cerebral infarction within 7 days post TIA(r=0.46, P<0.05). In 3D ASL cerebral perfusion imaging, 22 patients were in normal perfusion group, and 1 case of them had cerebral infarction within 7 days(4.5%), and 9 cases of 23 patients in hypoperfusion group had cerebral infarction(39.1%), and the incidence of cerebral infarction of normal perfusion group was significantly lower than that of hypoperfusion group(χ^2=7.782, P<0.05). And 11 cases were low-risk of ABCD^2 score + low-perfusion

关 键 词：短暂性脑缺血发作 三维动脉自旋标记灌注成像 磁共振成像 ABCD2评分 脑梗死 

分 类 号：R445.2[医药卫生—影像医学与核医学]