DWI、DTI及3D-ASL定量参数在AIS预后判断中的应用价值  

Application value of DWI, DTI and 3D-ASL quantitative parameters in the prognosis of AIS

作　　者：陈玉昆 滕佳歧 王娟[1] 秦丹 郭玥 李优伟 CHEN Yu-kun;TENG Jia-qi;WANG Juan(Department of Radiology,Beijing Rehabilitation Hospital,Capital Medical University,Beijing 100144,China)

机构地区：[1]首都医科大学附属北京康复医院放射科,北京100144

出　　处：《临床和实验医学杂志》2023年第7期754-757,共4页Journal of Clinical and Experimental Medicine

基　　金：北京市科技支撑重点项目(编号:Z101107052210002)。

摘　　要：目的探讨扩散加权成像(DWI)、弥散张量成像(DTI)及三维动脉自旋标记(3D-ASL)定量参数在急性缺血性脑卒中(AIS)预后判断中的应用价值。方法回顾性选取2020年1月至2022年1月在首都医科大学附属北京康复医院接受治疗的AIS患者110例作为研究对象,根据改良Rankin量表(mRS)分为预后良好组59例,预后不良组患者51例。比较预后良好组和预后不良组患者的临床资料、DWI、DTI和3D-ASL定量参数差异。分析DWI、DTI及3D-ASL定量参数与梗死面积、NIHSS评分的相关性,并分析DWI、DTI及3D-ASL定量参数预测预后不良的价值。结果预后不良组患者梗死面积和入院时美国国立卫生研究院卒中量表(NIHSS)评分分别为(13.22±1.19)cm^(2)和(10.84±1.21)分,明显高于预后良好组患者,差异均有统计学意义(P<0.05)。预后不良组患者病灶表观弥散系数(ADC)值、相对表观弥散系数(rADC)值、各项异性指数(FA)值、相对各项异性指数(rFA)值、脑血流量(CBF)和相对血流量(rCBF)分别为(0.30±0.09)×10^(-3) mm^(2)/s、0.46±0.10、0.23±0.06、0.55±0.12、(22.10±9.92)mL·100 g^(-1)·min^(-1)和0.44±0.14,均明显低于预后良好组患者,差异均有统计学意义(P<0.05);预后不良组和预后良好组患者平均弥散吸收(Dcavg)值和相对弥散吸收(rDCavg)值比较,差异均无统计学意义(P>0.05)。ADC值、rADC值与梗死面积呈负相关(P<0.05),ADC值、rADC值、FA值、rFA值、CBF值和rCBF值与NIHSS评分呈负相关(P<0.05)。ADC值、rADC值、FA值、rFA值、CBF值和rCBF值预测预后不良的受试者工作特征曲线下面积分别为0.673、0.769、0.824、0.793、0.830和0.900,其中ADC值预测价值较低,rCBF值预测价值较高。结论DWI、DTI及3D-ASL定量参数与AIS患者梗死面积、病情严重程度存在相关性,同时在预测AIS患者预后方面有一定应用价值。Objective To explore the value of diffusion weighted imaging(DWI),diffusion tensor imaging(DTI)and three-dimensional arterial spin labeling(3D-ASL)quantitative parameters in predicting the prognosis of acute ischemic stroke(AIS).Methods A total of 110 patients with AIS who were treated in Beijing Rehabilitation Hospital,Capital Medical University from January 2020 to January 2022 were selected and divided into 59 patients in good prognosis and 51 patients in poor prognosis patients according to the modified Rankin scale(mRS).Clinical data,DWI,DTI and 3D-ASL quantitative parameters of patients with good and poor prognosis were compared.The correlation between DWI,DTI and 3D-ASL quantitative parameters and infarct size and NIHSS score were analyzed,and the value of DWI,DTI and 3D-ASL quantitative parameters in predicting poor prognosis were analyzed.Results The infarct size and the National Institutes of Health Stroke Scale(NIHSS)score on admission of patients with poor prognosis group were(13.22±1.19)cm^(2) and(10.84±1.21),respectively,which were significantly higher than those of patients with good prognosis group,the differences were statistically significant(P<0.05).The apparent diffusion coefficient(ADC),relative apparent diffusion coefficient(rADC),fractional anisotropy index(FA),relative fractional anisotropy index(rFA),cerebral blood flow(CBF)and relative blood flow(rCBF)of patients with poor prognosis group were(0.30±0.09)×10^(-3) mm^(2)/s,0.46±0.10,0.23±0.06,0.55±0.12,(22.10±9.92)mL·100 g^(-1)·min^(-1) and 0.44±0.14,which were significantly lower than those of patients in good prognosis group,the differences were statistically significant(P<0.05).There was no statistically significant difference in average diffusion coefficient(Dcavg)and relative average diffusion coefficient(rDCavg)between poor and good prognosis patients(P>0.05).ADC value and rADC value were negatively correlated with infarct size(P<0.05).ADC value,rADC value,FA value,rFA value,CBF value and rCBF value were negatively correla

关 键 词：扩散加权成像 弥散张量成像 三维动脉自旋标记 定量参数 急性缺血性脑卒中 预后 预测价值 

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]