动脉自旋标记成像评估颈内动脉狭窄患者脑血流量  

Arterial spin labeling imaging in evaluation of cerebral blood flow in patients with internal carotid artery stenosis

作　　者：时彤彤 徐加焕 谢元忠[2] 李秀娟[2] 张立涛[2] 翟亚伟 姚志杰 SHI Tongtong;XU Jiahuan;XIE Yuanzhong;LI Xiujuan;ZHANG Litao;ZHAI Yawei;YAO Zhijie(Graduate School, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an 271000, China;Department of Radiology, Tai'an Central Hospital, Tai'an 271000, China)

机构地区：[1]山东第一医科大学山东省医学科学院研究生院,山东泰安271000 [2]泰安市中心医院医学影像部,山东泰安271000

出　　处：《中国介入影像与治疗学》2020年第6期364-368,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨以动脉自旋标记(ASL)成像评估颈内动脉狭窄患者脑血流量(CBF)的可行性。方法对30例一侧颈内动脉狭窄患者分别行MR平扫、DWI、三维时间飞跃(3D-TOF)及ASL序列扫描。根据3D-TOF序列图像将颈内动脉狭窄程度分为轻度、中度及重度,分别计算并对比健侧、患侧基底核区、半卵圆中心、前分水岭区、额叶皮质及颞叶皮质CBF。结果一侧颈内动脉轻度狭窄11例、中度狭窄9例、重度狭窄10例。轻度及中度狭窄患者健侧与患侧基底核区、半卵圆中心、前分水岭区、额叶皮质及颞叶皮质CBF差异均无统计学意义(P均>0.05),而重度狭窄患者健侧脑区CBF均高于患侧(P均<0.05)。上述脑区CBF值随狭窄程度增加而逐渐减小(P均<0.05),颈内动脉狭窄程度与患侧大脑半球CBF呈高度负相关(r=-0.966,P<0.001)。结论ASL可定量、准确评估颈内动脉狭窄患者CBF,对指导临床治疗和评估疗效具有重要意义。Objective To explore the feasibility of arterial spin labeling(ASL)imaging in assessment of cerebral blood flow(CBF)in patients with internal carotid artery stenosis.Methods Plain MR,DWI,three dimensional time of flight(3D-TOF)and ASL scanning were performed in 30 patients with unilateral internal carotid artery stenosis.Then the patients were divided into mild stenosis,moderate stenosis and severe stenosis cases according to 3D-TOF imaging.CBF of basal ganglia,centrum semiovale,anterior watershed,frontal lobe and temporal lobe were calculated and compared between the healthy side and the affected side.Results One side internal carotid artery stenosis was mild in 11 cases,moderate in 9 cases and severe in 10 cases.There was no significant difference of CBF between the healthy side and the affected side of basal ganglia,centrum semiovale,anterior watershed,frontal lobe nor temporal lobe in patients with mild and moderate stenosis(all P>0.05),while CBF of healthy side of each brain area in patients with severe stenosis were all higher than in the affected side(all P<0.05).CBF value decreased with the increase of stenosis degree and negatively correlated with the latter(r=-0.966,P<0.001).Conclusion ASL can quantitatively and accurately evaluate CBF in patients with internal carotid artery stenosis,which is of great significance for guiding clinical treatment and evaluating curative effect.

关 键 词：颈动脉狭窄 磁共振成像 动脉自旋标记 脑血流 

分 类 号：R543.5[医药卫生—心血管疾病] R445.2[医药卫生—内科学]