双期动脉自旋标记联合区域性动脉自旋标记技术在烟雾病血运重建术后脑灌注评估中的应用价值  

Application value of two-phase arterial spin labeling combined with territorial arterial spin labeling in the evaluation of cerebral perfusion after moyamoya disease revascularization

作　　者：徐肖肖 仲海[1] 孟庆虎[2] 张昌磊[1] 李娟[1] XU Xiaoxiao;ZHONG Hai;MENG Qinghu;ZHANG Changlei;LI Juan(Department of Radiology,the Second Hospital of Shandong University,Ji’nan 250033,China;Department of Neurosurgery,the Second Hospital of Shandong University,Ji’nan 250033,China)

机构地区：[1]山东大学第二医院影像科,山东济南250033 [2]山东大学第二医院神经外科,山东济南250033

出　　处：《实用放射学杂志》2025年第3期506-509,共4页Journal of Practical Radiology

摘　　要：目的 应用双期动脉自旋标记(ASL)联合区域性动脉自旋标记(t-ASL)技术评估烟雾病血运重建术后脑灌注的变化.方法 回顾性选取进行血运重建手术的烟雾病患者34例,共37个大脑半球,患者术前、术后分别进行了ASL[标记后延迟时间(PLD)1.5 s、2.5 s]、t-ASL及数字减影血管造影(DSA)检查.比较术前与术后ASL大脑中动脉(MCA)供血区域脑血流量(CBF)值和相对脑血流量(rCBF)值的差异.t-ASL和DSA对术后血运重建面积按3分制进行评分,采用加权Kappa比较2种方式评价血运重建面积的一致性.以DSA>1分为血运重建良好,对比ASL(PLD 1.5 s、2.5 s)与t-ASL对血运重建的诊断效能.结果 ASL PLD 1.5 s时术前与术后CBF值分别为(32.65±12.71)mL·100 g^(-1)·min^(-1)、(43.09±18.05)mL·100 g^(-1)·min^(-1),rCBF值为0.76±0.23、1.02±0.31;ASL PLD 2.5 s时术前与术后CBF值分别为(47.07±13.28)mL·100 g^(-1)·min^(-1)、(52.85±14.98)mL·100 g^(-1)·min^(-1),rCBF值为1.21±0.31、1.33±0.29,其前后差异均有统计学意义(P<0.05).血运重建面积评分一致性较强,加权Kappa系数为0.729.受试者工作特征(ROC)曲线分析显示t-ASL曲线下面积(AUC)为0.982,ASL PLD 1.5 s CBF AUC为0.813,ASL PLD 2.5 s CBF AUC为0.794.结论 双期ASL联合t-ASL技术可以更好地对烟雾病血运重建术后脑血流进行评估,t-ASL对术后重建血流的评估效能更高.Objective To evaluate the changes in cerebral perfusion after moyamoya disease revascularization using two-phase arterial spin labeling(ASL)combined with territorial arterial spin labeling(t-ASL).Methods A retrospective selection was conducted on 34 moyamoya disease patients with 37 cerebral hemispheres who underwent revascularization surgery.ASL[post labeling delay(PLD)of 1.5 s and 2.5 s],t-ASL,and digital subtraction angiography(DSA)were performed before and after surgery.The cerebral blood flow(CBF)and relative cerebral blood flow(rCBF)values in the middle cerebral artery(MCA)supply area from ASL were compared before and after surgery.t-ASL and DSA were used to score the area of revascularization on a 3-point scale,and weighted Kappa was used to compare the consistency of the revascularization area assessments.A DSA score greater than 1 point was classified as good revascularization.The diagnostic efficacy of ASL(PLD 1.5 s,2.5 s)and t-ASL for revascularization were compared.Results In ASL PLD 1.5 s,the preoperative and postoperative CBF values were(32.65±12.71)mL·100 g^(-1)·min^(-1) and(43.09±18.05)mL·100 g^(-1)·min^(-1),respectively,and the rCBF values were 0.76±0.23 and 1.02±0.31;In ASL PLD 2.5 s,the preoperative and postoperative CBF values were(47.07±13.28)mL·100 g^(-1)·min^(-1)and(52.85±14.98)mL·100 g^(-1)·min^(-1),respectively,and the rCBF values were 1.21±0.31 and 1.33±0.29.There were statistically significant differences between preoperative values and postoperative values above(P<0.05).The revascularization area score showed strong consistency(weighted Kappa coefficient=0.729).Receiver operating characteristic(ROC)curve analysis revealed that t-ASL reflected the revascularization area with area under the curve(AUC)of 0.982,while ASL PLD 1.5 s and 2.5 s CBF reflected the revascularization area with AUC of 0.813 and 0.794,espectively.Conclusion The combination of two-phase ASL and t-ASL more effectively evaluates cerebral blood after moyamoya disease revascularization.Furthermore,t-ASL d

关 键 词：烟雾病 血运重建 动脉自旋标记 区域性动脉自旋标记 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]