动脉自旋标记联合区域性动脉自旋标记技术评估单侧大脑中动脉重度狭窄或闭塞患者侧支代偿  

Arterial spin labeling combined with territory arterial spin labelingtechnology for evaluating collateral compensation in patients withsevere stenosis or occlusion of unilateral middle cerebral artery

作　　者：刘蒋静 李晨[1] 林斌 王玲廷 周智鹏[1] LIU Jiangjing;LI Chen;LIN Bin;WANG Lingting;ZHOU Zhipeng(Department of Radiology,Affiliated Hospital of Guilin Medical College,Guilin 541001,China)

机构地区：[1]桂林医学院附属医院放射科,广西桂林541001

出　　处：《中国医学影像技术》2024年第4期526-530,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的 观察动脉自旋标记(ASL)联合区域性ASL(t-ASL)技术评估单侧大脑中动脉(MCA)重度狭窄或闭塞患者侧支代偿的价值。方法 回顾性选取52例单侧MCA重度狭窄或闭塞患者(病变组),根据相对脑血流量(rCBF)将其进一步分为侧支循环不良亚组(n=23)及良好亚组(n=29);以55名健康体检者为对照组。基于ASL[标记后延迟时间(PLD)=1 525、2 525 ms]和t-ASL图像比较组间及病变组内亚组间脑血流量(CBF)、rCBF及CBF差值(PLD 2 525 ms下CBF-PLD 1 525 ms下CBF),观察侧支代偿来源;以Kendall相关性分析评估各参数与代偿的相关性。结果 病变组患侧与对照组左侧CBF、CBF差值的差异及组间rCBF差异均有统计学意义(P均<0.001),且2组PLD=2 525 ms下CBF均大于PLD=1 525 ms(P均<0.05),病变组患侧CBF均小于对侧(P均<0.05)。病变组内2亚组间CBF差值、患侧CBF及rCBF差异(P均<0.001),以及侧支无代偿和对侧颈内动脉(ICA)+椎基底动脉(VBA)代偿占比差异均有统计学意义(P均<0.05)。病变组rCBF(PLD=2 525 ms)与存在VBA侧支代偿呈低度正相关(r=0.397,P=0.004)。结论 ASL联合t-ASL有助于评估单侧MCA狭窄或闭塞患者侧支代偿情况。Objective To observe the value of arterial spin labeling(ASL)combined with territory ASL(t-ASL)technology for evaluating collateral compensation in patients with severe stenosis or occlusion of unilateral middle cerebral artery(MCA).Methods Data of 52 patients with severe stenosis or occlusion of unilateral MCA(lesion group)were retrospectively analyzed.The patients were divided into poor collateral circulation subgroup(n=23)or good subgroup(n=29)based on relative cerebral blood flow(rCBF).Meawhile,55 healthy subjects were taken as controls(control group).Based on ASL(post labeling delay[PLD]=1525,2525 ms)and t-ASL images,cerebral blood flow(CBF),rCBF and CBF difference(CBF in PLD 2525 ms-CBF in PLD 1525 ms)were compared between groups and subgroups within lesion group,and the source of collateral compensation was observed.The correlations of the above parameters and compensation status were explored using Kendall correlation analysis.Results Significant differences of CBF and CBF difference were found between the affected side of lesion group and the left side of control group,as well as of rCBF between groups(all P<0.001).In both groups,CBF on PLD=2525 ms images were greater than that on PLD=1525 ms images(both P<0.05),and CBF in the affected side was smaller than that in the opposite side in lesion group(all P<0.05).Significant differences of CBF and rCBF in the affected side,also of CBF difference(all P<0.001),as well as of the proportion of non collateral compensation and contralateral internal carotid arteria(ICA)+vertebral basilar artery(VBA)compensation were found between subgroups within lesion group(both P<0.05).In lesion group,rCBF(PLD=2525 ms)had low positive correlation with the presence of VBA collateral compensation(r=0.397,P=0.004).Conclusion ASL combined with t-ASL were helpful for evaluating collateral compensation in patients with unilateral MCA stenosis or occlusion.

关 键 词：大脑中动脉 狭窄 闭塞 侧支循环 动脉自旋标记 灌注成像 

分 类 号：R743[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]