体素内不相干运动成像对脑小血管病脑白质损害的评估价值  

Valuation value of intravoxel incoherent motion imaging on white matter damage in cerebral small vessel disease

作　　者：孙亚鸣[1] 张志国[2] SUN Ya-ming;ZHANG Zhi-guo(Department of Neurology,Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine,Zhangjiagang 215600,China;Department of Radiology,Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine,Zhangjiagang 215600,China)

机构地区：[1]南京中医药大学附属张家港医院神经内科,江苏张家港215600 [2]南京中医药大学附属张家港医院放射科,江苏张家港215600

出　　处：《吉林医学》2022年第5期1192-1195,共4页Jilin Medical Journal

基　　金：苏州市科技发展计划项目(民生科技)项目[项目编号:SYSD2017006]。

摘　　要：目的:探讨有无症状性腔隙性脑梗死患者脑组织微循环灌注的差异,估计体素内不相干运动成像(IVIM)对脑小血管脑白质损害的评估价值。方法:选择临床诊断为急性腔隙性脑梗死患者和无症状性腔隙性脑梗死患者各30例,均获得相应部位IVIM相关参数,包括标准表观扩散系数(Standard ADC)、慢速表观扩散系数(Slow ADC)、快速表观扩散系数(Fast ADC)等,并用Fazekas量表评分判断脑白质损害程度。结果:以无症状腔隙性脑梗死为对照,急性症状性患者深部白质及侧脑室旁Standard ADC、Slow ADC及Fast ADC明显降低,差异有统计学意义(P<0.001),急性症状性患者随访1年后深部白质及侧脑室旁Standard ADC值、Slow ADC值及Fast ADC值较急性期明显升高,差异有统计学意义(P<0.001),急性症状性患者侧脑室旁Slow ADC值下降、1年后随访Slow ADC值升高及变化值均与脑白质Fazekas评分呈正相关。结论:IVIM成像可通过相关参数指标评估局部脑组织微循环灌注情况,并与脑白质损害存在一定的相关性,有助于临床早期判断脑白质损害程度。Objective To investigate the difference of cerebral microcirculation perfusion between patients with and without symptomatic lacunar infarction and to estimate the value of intravoxel incoherent motion imaging(IVIM) in the evaluation of small cerebral vascular white matter damage.Method 30 patients with acute lacunar cerebral infarction and 30 patients with asymptomatic lacunar cerebral infarction were selected. The relevant parameters of IVIM were obtained, including standard apparent diffusion coefficient(standard ADC), slow apparent diffusion coefficient(slow ADC) and fast apparent diffusion coefficient(fast ADC). the degree of white matter damage was judged by Fazekas scale score.Results Compared with asymptomatic lacunar infarction, the deep white matter and paraventricular standard ADC, slow ADC and fast ADC in acute symptomatic patients decreased significantly(P<0.001). After one year of follow-up, the deep white matter and paraventricular standard ADC, slow ADC and fast ADC in acute symptomatic patients increased significantly(P<0.001), and the paraventricular slow ADC in acute symptomatic patients decreased After 1 year follow-up, the increase and change of slow ADC were positively correlated with Fazekas score of cerebral white matter.Conclusion IVIM can evaluate the microcirculation perfusion of local brain tissue through relevant parameters, and has a certain correlation with brain white matter damage, which is helpful to judge the degree of brain white matter damage in the early stage of clinic.

关 键 词：脑小血管病 白质损害 磁共振成像 体内不相干运动成像 

分 类 号：R743[医药卫生—神经病学与精神病学]