磁共振3DASL灌注成像在超急性脑梗塞中的诊断价值  

Diagnostic Value of Magnetic Resonance 3DASL Perfusion Imaging in Hyperacute Cerebral Infarction

作　　者：苏红兵 雷武刚 梅海英[1] SU Hong-bing;LEI Wu-gang;MEI Hai-ying(Department of Radiology,Fengcheng People's Hospital,Fengcheng 331100,Jiangxi,China)

机构地区：[1]丰城市人民医院放射科,江西丰城331100

出　　处：《医学信息》2022年第24期148-150,共3页Journal of Medical Information

摘　　要：目的研究磁共振3DASL灌注成像在超急性脑梗塞中的诊断价值。方法选取2020年11月-2021年12月在我院诊治的108例超急性脑梗塞患者为观察组,并选取同期在我院健康体检者100例为对照组,均进行磁共振常规扫描(MRI)、MRI联合磁共振3DASL灌注成像技术(3DASL)检查。观察两组患者脑血流量(CBF)、超急性脑梗塞患者左侧和右侧CBF、梗塞侧和镜像健侧CBF、不同标记后延迟时间(PLD)下CBF、MRI和MRI联合3DASL灌注成像诊断效能、不同诊断方法对超急性脑梗塞诊断准确率与病理结果的一致性以及超急性脑梗塞和脑出血影像学特点。结果观察组患者CBF与对照组CBF比较,差异无统计学意义(P>0.05);超急性脑梗塞患者左侧和右侧CBF比较,差异无统计学意义(P>0.05),梗塞侧CBF低于镜像健侧(P<0.05);3DASL灌注成像,PLD2.0s、PLD2.5s的CBF均高于PLD1.5s(P<0.05);常规MRI联合3DASL成像技术敏感度、特异度、准确性、阳性预测值、阴性预测值均高于常规MRI诊断(P<0.05);常规MRI联合3DASL成像技术对超急性脑梗塞的诊断准确率与病理结果具有高度一致性,且一致性高于MRI单独检测(P<0.05);超急性脑梗塞在病灶边缘、血流信号、是否存在缺血半暗带方面存在差异。结论磁共振3DASL灌注成像在超急性脑梗塞诊断中具有较高的价值,可联合常规MRI提高诊断效能,利于病灶部位血流灌注情况判断,并利于评价梗死区域责任动脉是否存在出血风险,对临床超急性脑梗塞的溶栓治疗具有重要的指导。Objective To study the diagnostic value of magnetic resonance 3DASL perfusion imaging in hyperacute cerebral infarction.Methods A total of 108 patients with hyperacute cerebral infarction diagnosed and treated in our hospital from November 2020 to December 2021 were selected as the observation group,and 100 healthy subjects in our hospital during the same period were selected as the control group.All patients underwent conventional magnetic resonance imaging(MRI),MRI combined with magnetic resonance 3DASL perfusion imaging(3DASL).The diagnostic efficacy of cerebral blood flow(CBF),left and right CBF,infarct side and mirror healthy side CBF,CBF under different post-labeling delay time(PLD),MRI and MRI combined with 3DASL perfusion imaging,the consistency of diagnostic accuracy and pathological results of different diagnostic methods for hyperacute cerebral infarction,and the imaging characteristics of hyperacute cerebral infarction and cerebral hemorrhage were observed.Results There was no significant difference in CBF between the observation group and the control group(P>0.05).There was no significant difference in CBF between the left and right sides of patients with hyperacute cerebral infarction(P>0.05).The CBF of the infarct side was lower than that of the mirror healthy side(P<0.05).The CBF of PLD2.0s and PLD2.5s was higher than that of PLD1.5s in 3DASL(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of conventional MRI combined with 3DASL imaging were higher than those of conventional MRI(P<0.05).The diagnostic accuracy of conventional MRI combined with 3DASL imaging for hyperacute cerebral infarction was highly consistent with pathological results,and the consistency was higher than that of MRI alone(P<0.05).There are differences in lesion edge,blood flow signal and ischemic penumbra in hyperacute cerebral infarction.Conclusion Magnetic resonance 3DASL perfusion imaging has high value in the diagnosis of hyperacute cerebral infarction.It can be combined

关 键 词：磁共振 3DASL灌注成像 超急性脑梗塞 

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]