多模态MRI功能成像联合应用诊断急性脑梗死的价值  

作　　者：邢小炜 高铖铖 胡成一[1] 钱琦[1] 

机构地区：[1]浙江中医药大学附属第三医院,310005

出　　处：《浙江临床医学》2021年第1期107-109,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨磁共振扩散加权成像(DWI)联合三维动脉自旋标记(3D-ASL)成像的多模态MRI功能成像在急性脑梗死(ACI)诊断中的应用价值。方法收集ACI患者68例,进行磁共振常规序列、DWI和3D-ASL成像检查,测量DWI异常高信号面积(Sowl)和3D-ASL异常灌注面积(S3D-ASL),比较两者差异;选取DWI扩散受限及3D-ASL灌注异常感兴趣区(ROI)和对侧镜像区,测量表观扩散系数(ADC)及脑血流(CBF)值,采用配对t检验,观察病变区和镜像区ADC、CBF值差异性;采用pearson检验,分析ADC和CBF值相关性;绘制受试者工作特征(ROC)曲线,并通过回归分析,比较ADC、CBF值及两参数联合检测对ACI的诊断效能。结果45例S3D-ASL/SDWI≥1.1,23例S3D-ASL≈SDWI,无S3D-ASL<SDWI。病变区DWI信号增高,ADC值较镜像区降低[(0.43±0.12)vs(0.65±0.19)μm^2/ms,P<0.05];病变区ASL灌注减低,CBF值较镜像区降低[(22.15±6.9)vs(44.63±11.40)ml/100 g·min,P<0.05]。ADC和CBF值呈正相关(r=0.89,P<0.05)。ROC曲线结合回归分析,联合ADC和CBF两个参数诊断效能最高(灵敏度92.60%,特异度92.60%,曲线下面积为0.98)。结论DWI联合3D-ASL多模态MRI功能成像有利于提高急性脑梗死的诊断效能。Objective To research the value of diffusion weighted imaging(DWI)combined with three dimensional arterial spin labeling imaging(3D-ASL)in the diagnosis of acute cerebral infarction.Methods Conventional magnetic resonance imaging,DWI and 3D-ASL imaging were performed in 68 cases of acute cerebral infarction in our hospital.The DWI abnormal signal area(SDWI)and 3D-ASL abnormal perfusion area(S3D-ASL)were measured,and the differences were compared.Apparent diffusion coefficient(ADC)and cerebral blood flow(CBF)were measured and compared in lesion area and mirror area.Thcn Pearson test was used to analyze the correlation between ADC and CBF,and the ROC curve was drawn to compare the diagnostic efficacy of ADC and CBF in acute cerebral infarction.Results 45 cases had S3D-ASL/SDWI≈1.1,23 cases had S3D-ASL≈SDWI,no cases had S3D-ASL<SDWI.The ADC and CBF values of ischemic lesion area were significantly lower than those of the mirror area of the opposite healthy side(0.43±0.12 vs 0.65±0.19 um^2/ms,P<0.05;22.15±6.92 vs 44.63±11.40 ml/100 g·min,P<0.05,respectively).A positive correlation was detected between ADC and CBF(r=0.89,P<0.05).The combination of ADC and CBF performed best in the diagnosis of ACI with the area of under ROC curve(AUC=0.98).Conclusions DWI combined with 3D-ASL scan can improve the diagnostic efficiency of acute cerebral infarction.

关 键 词：多模态磁共振 磁共振扩散加权成像 三维动脉自旋标记 急性脑梗死 

分 类 号：R74[医药卫生—神经病学与精神病学]