磁共振3D-ASL技术在急性脑梗死伴偏瘫患者侧支循环评估及近期预后预测中的临床价值  

Clinical Value of Magnetic Resonance 3D-ASL Technique in Collateral Circulation Assessment and Short-Term Prognosis Prediction of Patients with Acute Cerebral Infarction and Hemiplegia

作　　者：朱俊莎 ZHU Junsha(Department of Imaging,Jining Third People’s Hospital,Jining 272000,China)

机构地区：[1]山东省济宁市第三人民医院影像科,山东济宁272000

出　　处：《中国伤残医学》2025年第1期93-96,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨磁共振三维动脉自旋标记成像(3D-ASL)技术在急性脑梗死伴偏瘫患者侧支循环评估及近期预后预测中的临床价值。方法:回顾性分析2023年1月—2024年10月济宁市第三人民医院收治的68例急性脑梗死伴偏瘫患者资料,依据侧支循环情况将其分为侧支循环充分组(n=37)和侧支循环不充分组(n=31)。所有患者在急性期24h内均接受磁共振3D-ASL成像评估脑血流灌注,分析脑梗死灶、侧支循环及正常脑区的血流变化。评估两组临床恢复情况、磁共振3D-ASL成像结果与临床恢复情况的相关性。结果:两组正常脑区脑血流(CBF)值相比,差异无统计学意义(P>0.05)。侧支循环不充分组梗死灶区及侧支循环区CBF值均低于侧支循环充分组,差异均有统计学意义(P<0.05)。侧支循环充分组的预后良好率及预后中度率均高于侧支循环不充分组,预后差率低于侧支循环不充分组,差异均有统计学意义(P<0.05)。Spearman相关分析结果显示,梗死灶区的CBF与改良Pankin评分呈负相关,侧支循环区的CBF与量表评分呈正相关,侧支循环区的CBF与梗死灶区的CBF呈负相关(P<0.05)。结论:侧支循环的充分性与梗死灶区的缺血程度密切相关,磁共振3D-ASL技术能够有效评估急性脑梗死患者的侧支循环功能,并预测近期预后,为临床治疗提供参考。Objective:To investigate the clinical value of magnetic resonance three-dimensional magnetic resonance arterial spin labeling imaging(3D-ASL)technigue in collateral circulation assessment and short-term prognosis prediction in patients with acute cerebral infarction and hemiplegia.Methods:The data of 68 patients with acute cerebral infarction and hemiplegia treated in Jining Third People’s Hospital from January 2023 to October 2024 were retrospectively analyzed.According to the condition of collateral circulation,the patients were divided into an adequate collateral circulation group(n=37)and an inadequate collateral circulation group(n=31).All patients underwent magnetic resonance 3D-ASL imaging to evaluate cerebral blood perfusion within 24 h of acute phase,and analyze cerebral infarction,collateral circulation and normal cerebral blood flow changes.The clinical recovery status of two groups,correlation between clinical recovery status and the results of magnetic resonance three-dimensional magnetic resonance arterial spin labeling imaging were evaluated.Results:There was no significant difference in Cerebral bolld flow(CBF)between the two groups(P>0.05).The CBF values of infarction area and collateral circulation area in inadequate collateral circulation group were lower than those in adequate collateral circulation group,the differences were statistically significant(P<0.05).The rates of good prognosis and moderate prognosis in the adequate collateral circulation group were higher than those in the inadequate collateral circulation group,and the poor prognosis was lower than that in the inadequate collateral circulation group,with statistical significance(P<0.05).Spearman correlation analysis results showed that the CBF in the infarction area was negatively correlated with the modified Rankin Scale score,the CBF in the collateral circulation area was positively correlated with the modified Rankin Scale score,and the CBF in the collateral circulation area was negatively correlated with the CBF in the infarct

关 键 词：急性脑梗死伴偏瘫 磁共振三维动脉自旋标记成像 侧支循环 

分 类 号：R743.3[医药卫生—神经病学与精神病学]