灌注加权成像/弥散加权成像图像融合半定量评估缺血性脑卒中病人缺血半暗带价值分析  

Analysis of the value of perfusion⁃weighted imaging/diffusion weighted imaging image fusion in semi⁃quantitative evaluation of ischemic penumbra in patients with ischemic stroke

作　　者：胡明辉[1] HU Minghui(MR Laboratory,Henan Traditional Chinese Medicine Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]河南省中医院磁共振室,河南郑州450000

出　　处：《安徽医药》2020年第9期1825-1827,I0006,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探究灌注加权成像(PWI)/弥散加权成像(DWI)融合成像半定量评估缺血性脑卒中(IS)病人缺血半暗带价值分析。方法选择2015年2月至2018年3月河南省中医院收治的61例IS病人纳入研究,所有病人均行T1加权成像(T1WI)、T2加权成像(T2WI)、液体衰减反转恢复(FLAIR)、DWI、PWI多模式磁共振(MR)扫描,分别采用基于图像融合的灌注-弥散加权成像不匹配(PDM)半定量评估及基于体积测定的灌注-弥散体积不匹配(V-PDM)评估病人缺血半暗带,比较两种方法测定时间及一致性。结果基于图像融合PDM半定量评估耗时(145.61±40.22)s,V-PDM耗时(326.52±75.41)s,两者比较差异有统计学意义(P<0.05);V-PDM阳性组病人不匹配区域分值为2.5(1.0,4.0),阴性组为0.5(-1.0,0.5),组间比较差异有统计学意义(P<0.05);以V-PDM为金标准,基于图像融合PDM半定量评估诊断灵敏度、特异度、准确度分别为71.4%、92.3%及80.3%,Kappa一致性检验值为0.613。结论 PWI/DWI图像融合可有效评估IS病人缺血半暗带PDM,缩短测定时间,且与V-PDM测定结果具有较高的一致性。Objective To explore the value of perfusion weighted imaging(PWI)/diffusion weighted imaging(DWI)fusion image in semi⁃quantitative evaluation of ischemic penumbra in patients with ischemic stroke(IS).Methods 61 patients with IS who were admitted and treated in Henan Traditional Chinese Medicine Hospital from February 2015 to March 2018 were enrolled in the study.All patients underwent T1⁃weighted imaging(T1WI),T2⁃weighted imaging(T2WI),fluid⁃attenuated inversion recovery(FLAIR),DWI and PWI multi⁃mode magnetic resonance(MR)scanning.PWI⁃DWI mismatch(PDM)semi⁃quantitative assessment based on image fusion and volume⁃based PDM(V⁃PDM)were performed to assess deficiency blood penumbra of patients.Time and consistencies of the two methods were compared.Results The time of PDM semi⁃quantitative evaluation based on image fusion and V⁃PDM were(145.61±40.22)s and(326.52±75.41)s,respectively.The difference between the two was statistically significant(P<0.05).The unmatched area scores of V⁃PDM positive group and V⁃PDM negative group were 2.5(1.0,4.0)and 0.5(-1.0,0.5),respectively(P<0.05).With V⁃PDM as the golden standard,the sensitivity,specificity and accuracy of PDM semi⁃quantita⁃tive evaluation based on image fusion were 71.4%,92.3%and 80.3%,respectively.The Kappa value was 0.613.Conclusion PWI/DWI image fusion can effectively assess ischemic penumbra in patients with IS and shorten the measurement time,with high consis⁃tency with V⁃PDM.

关 键 词：脑梗死/诊断 卒中/诊断 脑缺血 弥散张量成像 钆DTPA 缺血半暗带 灌注-弥散体积不匹配 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]