急性缺血性脑卒中多模态MRI的应用研究  

Application Study of Multimodal MRI in Acute Ischemic Stroke

作　　者：唐继芳[1] 马春[1] 张勇[1] 刘高元 惠庆桃[1] Tang Ji-Fang;Ma Chun;Zhang Yong;Liu Gao-yuan;Hui Qing-tao(Department of Radiology,Deyang People's Hospital,deyang 618000,SichuanProvince,China)

机构地区：[1]德阳市人民医院放射科,四川德阳618000

出　　处：《中国CT和MRI杂志》2022年第10期25-27,共3页Chinese Journal of CT and MRI

摘　　要：目的探究多模态MRI在急性缺血性脑卒中(AIS)中的应用价值。方法回顾性分析2019年1月至2019年10月67例AIS住院患者临床资料,患者入院48h内完成多模态MRI扫描,包括常规扫描序列及弥散加权成像(DWI)、磁敏感加权成像(SWI)、三维动脉自旋标记成像(3D-ASL)扫描,观察各扫描序列影像特征,并分析不同病因(心源性AIS组24例、非心源性AIS组43例)、病情(轻型14例、中型33例、重型20例)及预后(预后良好29例、尚可27例、预后不良11例)患者多模态MRI特征。结果67例AIS患者DWI序列下呈不规则斑片、点片状或斜形高信号影,梗死灶面积2.1cm2~34.2cm2,其中大面积梗死31例(46.27%),中面积梗死25例(37.31%),小面积梗死11例(16.42%),SWI图中CMB阳性18例(26.87%),SVS阳性36例(53.73%);3D-ASL图像提示病灶区域周围灌注状态高灌注18例(26.87%),正常灌注20例(29.85%),低灌注29例(43.28%);心源性AIS组SVS阳性率显著高于非心源性组(P<0.05);不同病情程度AIS组CMB阳性率、SVS阳性率、灌注状态比较差异有统计学意义(P<0.05),表现为中重型AIS患者CMB阳性率、SVS阳性率、低灌注状态显著高于轻型患者(P<0.05);不同预后组梗死面积、CMB阳性率、SVS阳性率、灌注状态比较差异有统计学意义(P<0.05),表现为预后良好组大梗死面积率、CMB阳性率、SVS阳性率、低灌注状态率更低(P<0.05)。结论多模态MRI检查可为AIS患者提供更丰富诊断信息,有助于患者病因、病情及预后判断。Objective To explore the application value of multimodal MRI in acute ischemic stroke(AIS).Methods The clinical data of 67 AIS inpatients from January 2019 to October 2019 were retrospectively analyzed.The patients completed multimodal MRI scan within 48h after admission,including conventional scan sequence and diffusion weighted imaging(DWI),susceptibility weighted imaging(SWI),and three-dimensional arterial spin-labeled imaging(3D-ASL)scan.The image characteristics of each scan sequence were observed,and the multimodal MRI features were analyzed among patients with different causes(24 cases in cardiogenic AIS group,43 cases in non-cardiogenic AIS group),disease conditions(14 cases of mild type,33 cases of moderate type,20 cases of severe type)and prognosis(29 cases with good prognosis,27 cases are fair prognosis,11 cases with poor prognosis).Results DWI sequence of 67 patients with AIS showed irregular patchy,dotted or oblique high-signal shadows,and the area of infarction lesions was 2.1cm2~34.2cm2,and there were 31 cases(46.27%)of large area infarction,25 cases of middle area infarction(37.31%)and 11 cases of small area infarction(16.42%),and SWI image showed18 CMB positive cases(26.87%)and 36 SVS positive cases(53.73%).3D-ASL images showed there were 18 cases with high perfusion(26.87%)around the lesion area,20 cases of normal perfusion(29.85%)and 29 cases of low perfusion(43.28%).The SVS positive rate in cardiogenic AIS group was significantly higher than that in non-cardiogenic group(P<0.05).There were statistically significant differences in the CMB positive rate,SVS positive rate and perfusion status among AIS group with different disease conditions(P<0.05),showing that the CMB positive rate,SVS positive rate and low perfusion status of patients with moderate-to-severe AIS were significantly higher than those of patients with mild AIS(P<0.05).Different There were statistically significant differences in the infarction area,CMB positive rate,SVS positive rate and perfusion status among different prognosis

关 键 词：缺血性脑卒中 磁共振成像 弥散加权成像 磁敏感加权成像 三维动脉自旋标记成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]