双时相3D-ASL、DWI与DSC-MRI灌注在TIA诊断中的对照研究  

Comparative study of dual phase 3D-ASL,DWI and DSC-MRI perfusion in the diagnosis of TIA

作　　者：缪华[1] MIAO Hua(Radiology Department,Nantong Rich Hospital,Nantong,Jiangsu 226010,China)

机构地区：[1]南通瑞慈医院放射科,江苏南通226010

出　　处：《影像研究与医学应用》2023年第4期53-56,共4页Journal of Imaging Research and Medical Applications

摘　　要：目的:对照分析双时相三维动脉自旋标记(three dimensional-arterial spin labeling,3D-ASL)成像技术、弥散加权成像(diffusion weighted imaging,DWI)与动态磁敏感对比增强MRI(dynamic susceptibility contrast MRI,DSC-MRI)在短暂性脑缺血发作(transient ischemic attack,TIA)诊断中的价值。方法:选取2019年9月—2020年10月于南通瑞慈医院经临床诊断为TIA的患者34例,检查时间窗均为发病24 h以内行头颅MRI检查,使用GE Pioneer 3.0T MRI扫描仪常规扫描T_(1)WI、T_(2)WI、FLAIR、DWI及双时相(PLD=1525 ms,2525 ms)3D-ASL检查,并行DSC-MRI灌注检查,对3D-ASL、DWI及DSC-MRI检查结果进行对照。结果:DWI结果显示阳性12例,PLD=1525 m s、2525 m s及DSC-MRI均检出低灌注区;DWI显示阴性22例,PLD=1525 m s检出低灌注15例,PLD=2525 m s检出低灌注7例,DSC-MRI检出轻度低灌注7例。DWI阳性组,3D-ASL与DSC-MRI检出效能一致;DWI阴性组,PLD=2525 ms检出效能与DSC-MRI大致相当,PLD=1525 ms检出效能更高(P<0.05);总体检出效能PLD=1525 ms高出其他检查(P<0.05),PLD=2525 ms与DSC-MRI检出效能基本相当,PLD=1525 ms检出CBF伪彩图低灌注面积大于PLD=2525 ms及DSC-MRI伪彩图低灌注面积(P<0.001)。结论:采用较短PLD 3D-ASL检查对缺血引起的低灌注敏感,检出效能更高,操作方便,能够早期发现缺血低灌注并指导临床个性化治疗。Objective To compare and analyze the value of dual phase three dimensional-arterial spin labeling(3D-ASL)imaging,diffusion weighted imaging(DWI)and dynamic susceptibility contrast MRI(DSC-MRI)in the diagnosis of transient ischemic attack(TIA).Methods 34 patients with TIA diagnosed clinically in Nantong Rich Hospital from September 2019 to October 2020 were selected,the examination time window was within 24 hours after the onset of TIA.GE Pioneer 3.0T MRI scanner was used to scan T1WI,T2WI,flair,DWI and dual phase(PLD=1525ms,2525ms)3D-ASL parallel DSC-MRI perfusion examination,the results of 3D-ASL,DWI and DSC-MRI were compared.Results DWI results showed positive in 12 cases,PLD=1525ms,2525ms and DSC-MRI detected hypoperfusion;22 cases of DWI negative results,PLD=1525ms detected hypoperfusion in 15 cases,PLD=2525ms detected hypoperfusion in 7 cases,DSC-MRI detected mild hypoperfusion in 7 cases.In DWI positive group,the detection efficiency of 3D-ASL was consistent with that of DSC-MRI;in DWI negative group,the detection efficiency of PLD=2525 ms was roughly the same as that of DSC-MRI,and PLD=1525 ms was significantly higher than that of other examinations(P<0.05);in total physical examination,the detection efficiency of PLD=1525 ms was significantly higher than that of other examinations(P<0.05),and PLD=2525ms was basically the same as that of DSC-MRI,and PLD=1525 ms was significantly higher than that of other examinations(P<0.05)The hypoperfusion area of pseudo color image was larger than that of PLD=2525 ms and DSC-MRI(P<0.001).Conclusion Short PLD 3D-ASL examination is sensitive to ischemia-induced hypoperfusion,with higher detection efficiency and convenient operation,which can early detect ischemia-induced hypoperfusion and guide clinical personalized treatment.

关 键 词：短暂性脑缺血发作 动态磁敏感对比增强 动脉自旋标记 

分 类 号：R445.2[医药卫生—影像医学与核医学]