3D-ASL对表现为孤立性眩晕的后循环缺血的诊断价值  

Clinical value of 3D-ASL in the assessment of isolated posterior circulation ischemia vertigo

作　　者：刘聪[1] 杨玉峰[1] 李建波[1] 李国平[1] 王建平[2] LIU Cong;YANG Yufeng;LI Jianbo;LI Guoping;WANG Jianping(Anyang Regional Hospital in Puyang City,Puyang 455000,China;The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]濮阳市安阳地区医院,河南濮阳455000 [2]郑州大学第一附属医院,河南郑州450052

出　　处：《中国实用神经疾病杂志》2019年第24期2691-2697,共7页Chinese Journal of Practical Nervous Diseases

基　　金：国家自然科学基金项目(编号:81771247)。

摘　　要：目的探讨磁共振三维动脉自旋标记成像(3D-ASL)在DWI阴性的临床表现为孤立性眩晕的后循环缺血中的诊断价值。方法回顾性分析DWI阴性的临床表现为孤立性眩晕后循环缺血的46例患者,均在发病48 h内行3D-ASL扫描,行双时相扫描(PLDl.5 s,2.5 s)ASL检查,评估不同时相双侧小脑CBF的差异,并计算双侧不对称指数(AI)。结果标记后延迟时间(PLD)为1.5 s时,小脑区低灌注检出42例,PLD为2.5 s时,低灌注检出为40例,其中32例行MRA分析时相应供血区的椎动脉或基底动脉有病变,不对称指数均在10%以上(P<0.05)。结论对疑似后循环缺血的患者,推荐早期常规行3D-ASL序列检查,为临床治疗方案的选择提供依据。Objective To explore the clinical value of three-dimensional spin-labeled imaging combined with routine examination of sequence scan(3D-ASL)in the assessment of isolated posterior circulation ischemic vertigo in DWI-negative patients.Methods A retrospective analysis of DWI-negative 46 patients with isolated posterior circulation ischemic vertigo.3D-ASL double-phase scan(PLD1.5 s,2.5 s)were performed within 48 hours.The cerebral blood flow of bilateral cerebellar hemisphere cerebellar was measured using 3D ASL and the asymmetry index(AI)was calculated.Results When the post-labeling delay time(PLD)was 1.5 s,42 cases of hypoperfusion in the cerebellum were detected.When the PLD was 2.5 s,40 cases of hypoperfusion in the cerebellum were detected,among which,vascular lesions of vertebral artery or basilar artery were found in 32 patients by MRA.The asymmetry index is above 10%(P<0.05).Conclusion For patients with suspected posterior circulation ischemia,early routine 3D-ASL sequence testing is recommended to provide a basis for the selection of clinical treatment options.

关 键 词：孤立性眩晕 后循环缺血 3D-ASL 

分 类 号：R743[医药卫生—神经病学与精神病学]