三维动脉自旋标记灌注成像联合磁共振血管成像对老年急性脑梗死缺血半暗带的评估价值  

Value of three dimensional-arterial spin labeling combined with magnetic resonance angiography in evaluating ischemic penumbra of elderly patients with acute cerebral infarction

作　　者：王卓[1] 赵艳生[1] 张亚杰[1] 陈丽[1] 杜鑫[2] Wang Zhuo;Zhao Yansheng;Zhang Yajie;Chen Li;Du Xin(Magnetic Resonance Room,Kailuan General Hospital,Tangshan 063000,Hebei,China;Department of Cardiology,Kailuan General Hospital,Tangshan 063000,Hebei,China)

机构地区：[1]开滦总医院磁共振室,河北唐山063000 [2]开滦总医院心血管科,河北唐山063000

出　　处：《血管与腔内血管外科杂志》2023年第3期355-358,共4页Journal of Vascular and Endovascular Surgery

基　　金：河北省重点研发项目(172777140)。

摘　　要：目的探讨三维动脉自旋标记灌注成像(3D-ASL)联合磁共振血管成像(MRA)对老年急性脑梗死缺血半暗带(IP)的评估价值。方法收集2019年1月至2020年的7月于开滦总医院就诊的84例老年急性脑梗死患者的临床资料,均行3D-ASL、MRA、弥散加权成像(DWI)检查,分析缺血性脑卒中的检出情况,比较梗死核心区域、IP区域、对侧健康区域的脑血流量(CBF)、表观扩散系数(ADC),观察血管狭窄分布情况。结果84例患者中大面积缺血性脑卒中61例,均存在3D-ASL异常;小面积缺血性脑卒中23例,其中3D-ASL异常7例。梗死核心区域、IP区域的CBF、ADC均明显低于对侧健康区域,差异均有统计学意义(P﹤0.05)。84例患者中,16例患者3D-ASL未见明显异常,其他68例3D-ASL异常患者的罪犯血管均存在程度不同的狭窄或闭塞,以0~1级为主,占77.9%(53/68)。结论3D-ASL联合MRA可准确判断老年急性脑梗死患者是否存在IP区域,为临床治疗决策提供依据。Objective To observe the value of three dimensional-arterial spin labeling(3D-ASL)combined with magnetic resonance angiography(MRA)in evaluating the ischemic penumbra(IP)of patients with acute cerebral infraction.Method From January 2019 to July 2020,84 elderly patients with acute cerebral infraction who were treated in the Kailuan General Hospital were selected.All patients underwent 3D-ASL,MRA,and diffusion weighted imaging(DWI).The detection of ischemic stroke was analyzed,the cerebral blood flow(CBF)and apparent diffusion coefficient(ADC)in the core area of infraction,IP and contralateral health area were compared and distribution of vascular stenosis was observed.Result In 84 patients,61 patients had large cerebral infraction),and 3D-ASL showed abnormal;23 patients had small cerebral infarction,of which 7 patients had 3D-ASL abnormal.The CBF and ADC in the core area of infraction and IP were lower than those in contralateral health area,the differences were statistically significant(P<0.05).Among the 84 patients,16 patients showed no significant abnormalities in 3D-ASL,while the other 68 patients with ASL abnormalities had varying degrees of stenosis or occlusion in the culprit's blood vessels,with grades 0-1 being the predominant,accounting for 77.9%(53/68).Conclusion 3D-ASL combined with MRA can accurately determine whether there is an ischemic penumbra in elderly patients with acute cerebral infraction,and provide a basis for clinical treatment.

关 键 词：老年 急性脑梗死 三维动脉自旋标记灌注成像 磁共振血管成像 缺血半暗带 

分 类 号：R543[医药卫生—心血管疾病]