磁共振三维准连续式动脉自旋标记成像在急性脑梗死患者中的应用  

Application of MRI 3D-pCASL in patients with acute cerebral infarction

作　　者：赵文超 宋雨[2] 唐晨虎[1] 吴雪 马东 姜亦伦 ZHAO Wenchao;SONG Yu;TANG Chenhu;WU Xue;MA Dong;JIANG Yilun(Department of Radiology,Nanjing Integrated Traditional Chinese and Western medicine Hospital,Nanjing 210014,China;Department of Ultrasound,Nanjing Integrated Traditional Chinese and Western Medicine Hospital,Nanjing 210014,China;Department of Neurology,Wuxi Xishan People's Hospital,Wuxi 214000,China)

机构地区：[1]南京中医药大学附属南京市中西医结合医院放射科,南京210014 [2]南京中医药大学附属南京市中西医结合医院超声科,南京210014 [3]无锡市锡山人民医院神经内科,无锡214000

出　　处：《磁共振成像》2020年第12期1156-1158,1166,共4页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的探讨磁共振三维准连续式动脉自旋标记(3D pseudo-continuous arterial spin labeling,3D-pCASL)成像在急性脑梗死患者中的临床应用价值。材料与方法分析急性脑梗死患者84例(脑梗死组),其中脑梗死组根据溶栓后有无出血转化,分为出血转化组(35例)和无出血转化组(49例)。另选取50例健康志愿者作为对照组。所有患者都经磁共振3D-pCASL检查,并进行统计学分析。结果脑梗死患者在常规MRI序列图像上呈现大脑半球大片低灌注区,远端血管分支未见显示,扩散加权成像(diffusion weighted imaging,DWI)均表现为明显高信号,ADC图像均表现为明显低信号。脑梗死患者病灶位于右侧大脑半球者54例,病灶位于左侧大脑半球者30例。脑梗死核心区相对脑血流量(relative cerebral blood flow,rCBF)绝对值和ADC值较对侧镜像区降低,且两侧rCBF绝对值和ADC值均低于健康对照组(P<0.05)。以3D-pCASL图像后处理参数rCBF进行ROC曲线分析,ROC下面积为0.915。出血转化组患者脑梗死核心区边缘rCBF绝对值和ADC值较无出血转化组高(P<0.05),以3D-pCASL图像后处理参数rCBF进行ROC曲线分析,ROC下面积为0.926。结论磁共振3D-pCASL可显示急性脑梗死患者梗死病灶的血液动力学状态的信息,结合rCBF可客观反映脑组织缺血梗死灌注改变,并对治疗后出血转化的预判有一定价值,为临床诊断提供影像学依据。Objective:To investigate the clinical value of three-dimensional pseudo-continuous arterial spin labeling(3 D-pCASL)in patients with acute cerebral infarction.Materials and Methods:A total of 84 patients with acute cerebral infarction(cerebral infarction group)were selected.The cerebral infarction group was divided into a hemorrhagic transformation group(35 cases)and a non-hemorrhagic transformation group(49 cases)according to the presence or absence of hemorrhagic transformation after thrombolysis.And 50 healthy volunteers were selected as the control group.All patients were examined by MRI 3 D-pCASL,and statistical analysis was performed.Results:MRI of cerebral infarction patients showed large cerebral hemisphere hypoperfusion regions,while no distal vascular branches were shown.DWI showed significantly high signals,and ADC images showed significantly low signals.In 54 patients with cerebral infarction,the lesion was located in the right cerebral hemisphere,while in 30 patients with cerebral infarction.the absolute value of rCBF and ADC value in the core area of cerebral infarction were lower than those in the contralateral mirror area;the absolute value of rCBF and ADC value in both sides were lower than those in the healthy control group(P<0.05).ROC curve analysis was carried out with 3 D-pCASL image post-processing parameter rCBF,and the area under ROC was 0.915.The absolute value of peripheral blood flow(rCBF)and ADC values in the cerebral infarction core area of patients in the hemorrhagic transformation group were higher than those in the non-hemorrhagic transformation group(P<0.05).ROC curve analysis was carried out with 3 D-pCASL image post-processing parameter rCBF,and the area under ROC was 0.926.Conclusions:3 D-p CASL can display the hemodynamic state information of infarction lesions in patients with acute cerebral infarction.Combined with rCBF.It can objectively reflect the changes of cerebral ischemic infarction perfusion,and has certain value in predicting hemorrhage transformation after treatmen

关 键 词：磁共振成像 三维准连续式动脉自旋标记 脑卒中 短暂性脑缺血发作 扩散加权成像 

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]