一站式多模态平扫MR动态成像在急性脑卒中的应用及对缺血半暗带的早期干预效果  

Application of one-stop multimodal dynamic magnetic resonance imaging in acute stroke and effects of early intervention on ischemic penumbra

作　　者：江宇 崔惠勤[1] JIANG Yu;CUI Huiqin(Department of Medical Imaging,The Fourth Affiliated Hospital of Guangxi Medical University(Liuzhou Workers'Hospital),Liuzhou 545005,China)

机构地区：[1]广西医科大学第四附属医院(柳州市工人医院)医学影像科,广西柳州545005

出　　处：《中国医学物理学杂志》2020年第3期307-310,共4页Chinese Journal of Medical Physics

基　　金：广西壮族自治区卫生和计划生育委员会计划项目(Z2016188);柳州市科学研究与技术开发计划项目(2016G020208)。

摘　　要：目的:探讨一站式多模态平扫MR动态成像在急性脑卒中的应用及对缺血半暗带的早期干预效果。方法:回顾性分析34例急性脑卒中患者影像资料。对比患者正常区域及病变区域的脑组织血流量(CBF)、造影剂平均峰值时间等参数。结果:弥散加权成像显示所有患者均有不同程度的高信号梗死灶,其中28例成像显示存在不同程度的狭窄与闭塞。在评价缺血半暗带方面,26例动态磁敏感对比增强(DSC)与磁共振动脉自旋标记(ASL)结果高度一致。8例患者两种检测结果不一致,ASL显示高灌注,而DSC显示正常灌注,DSC与ASL显示缺血半暗带无明显差异(P>0.05)。与正常对照区域各灌注成像参数相比,半暗带及梗死区域的中枢血容量(CBV)及CBF水平更低(P<0.05),平均通过时间(MTT)水平更高(P<0.05);与半暗带区域相比,梗死区域的CBF及CBV水平更低(P<0.05),MTT水平更高(P<0.05)。结论:一站式平扫MR可快速准确评价急性缺血性脑卒中,为临床个性化治疗提供客观的影像学依据。Objective To investigate the application of one-stop multimodal dynamic magnetic resonance(MR)imaging in the evaluation of acute stroke and discuss the effects of early intervention on ischemic penumbra.Methods The imaging data of 34 patients with acute stroke were analyzed retrospectively.The parameters such as brain blood flow(CBF)and the mean time-topeak of contrast agent were compared between normal area and lesion area.Results Diffusion-weighted imaging showed that all patients had different degrees of high signal infarcts,and that 28 patients had different degrees of stenosis and occlusion.In the evaluation of ischemic penumbra,there were 26 cases in which the results obtained by dynamic susceptibility contrast-enhanced MR imaging(DSC)were highly consistent with those obtained by arterial spin-labeling MR imaging(ASL).In the other 8 cases,the results obtained by DSC and ASL were inconsistent,and there was high perfusion in ASL and normal perfusion in DSC,but the ischemic penumbra displayed in DSC was similar to that in ASL,without significant differences(P>0.05).Compared with those in normal area,the levels of central blood volume and CBF in penumbra and infarct areas were lower(P<0.05),and mean transit time in the two areas was longer(P<0.05).Moreover,the levels of CBF and central blood volume in infarct area were lower than those in penumbra area(P<0.05),and the mean transit time in infarct area was longer than that in penumbra area(P<0.05).Conclusion One-stop MR plain scanning can be used to quickly and accurately evaluate acute ischemic stroke,thereby providing objective imaging basis for personalized treatment in clinic.

关 键 词：急性缺血性脑卒中 一站式多模态平扫 缺血半暗带 磁共振成像 灌注加权成像 磁敏感加权成像 

分 类 号：R816.1[医药卫生—放射医学]