SWI与3D-PCASL联合应用对急性脑梗死出血转化的预测研究

发布时间：2019-02-27 15:33

【摘要】：目的:探讨3.0T磁共振的磁敏感加权成像(SWI)与三维的准连续式动脉自旋标记技术(3D-PCASL)评价急性脑梗死后出血转化(HT),预测评估的临床应用价值。方法:54例急性脑梗死(72 h)均行常规MRI、3D-PCASL及SWI检查,利用SWI评估HT的类型,结合3D-PCASL获得梗死和HT区及病灶周围脑血流量(CBF)变化进行相关性分析。结果:本组54例急性脑梗死中有19例HT,其中出血性梗死(HI)型13例(HI-1型9例、HI-2型4例),脑血肿形成(PH)型6例(PH-1、2型各3例),HI和PH型的病灶区及病灶周围的局部脑血流量(rCBF)均值区分别为(32.787±10.876)mL/(100g·min)、(26.655±19.325)mL/(100g·min),(26.033±10.930)mL/(100g·min)、(28.984±11.019)mL/(100g·min),HI和PH型的病灶区的rCBF差异有统计学意义(t=0.766,P=0.000,0.01,t=0.834,P=0.041,0.05)。在54例急性脑梗死中,病灶内及周围高灌注出血分别占42.8%、50%,正常灌注区及周围出血分别占50%、37.5%,低灌注区及周围分别占31.7%、28.1%,急性脑梗死与HT病灶区及周围低、正常、高灌注的进行t检验分析具有统计学意义(t=0.658,P=0.002,0.01)。结论:SWI与3D-PCASL联合应用对急性脑梗死和HT病灶内及周围量化分析rCBF变化情况,对急性脑梗死HT预测,为临床制定正确的治疗方案和预后判断具有重要临床意义。
[Abstract]:Aim: to evaluate the clinical value of magnetic sensitivity weighted imaging (SWI) and three-dimensional quasi-continuous arterial spin labeling (3D-PCASL) in predicting the transformation of hemorrhage after acute cerebral infarction (ACI) by magnetic susceptibility weighted imaging (SWI) and three-dimensional quasi-continuous arterial spin labeling (3D-PCASL). Methods: routine MRI,3D-PCASL and SWI were performed in 54 patients with acute cerebral infarction (72 h). The type of HT was assessed by SWI. The correlation analysis of (CBF) changes between infarction and HT and peripheral cerebral blood flow was carried out with 3D-PCASL. Results: among the 54 cases of acute cerebral infarction, 19 cases of HT, 13 cases of hemorrhagic infarction (HI) type (9 cases of HI- type 1, 4 cases of HI- 2 type), 6 cases of cerebral hematoma forming (PH) type (3 cases of PH-1, 2 type), 3 cases of hemorrhagic infarction (3 cases of PH-1, 2 type). The mean regional cerebral blood flow (rCBF) of HI and PH were (32.787 卤10.876) mL/ (100g 路min), (26.655 卤19.325) mL/ (100g 路min), (26.033 卤10.930) mL/ (100g 路min), respectively. (28.984 卤11.019) mL/ (100 g 路min), HI, P = 0.000, 0.01, t = 0.834, P = 0.041, P < 0.01), there was a significant difference in rCBF between the lesions of 100 g 路min), HI and PH type (t = 0.76, P = 0.000, 0.01, P = 0.834, P < 0.01). In 54 cases of acute cerebral infarction, high perfusion hemorrhage in and around the lesion accounted for 42.8%, 50%, normal perfusion area and surrounding hemorrhage 50%, 37.5%, 31.7% and 28.1% respectively, and low perfusion area and surrounding area accounted for 31.7% and 28.1%, respectively. T-test was performed between acute cerebral infarction and HT with low, normal and high perfusion (t = 0.658, P = 0.002, 0.01). Conclusion: the combination of SWI and 3D-PCASL has important clinical significance in quantifying the changes of rCBF in and around acute cerebral infarction and HT, predicting the HT of acute cerebral infarction and making correct treatment plan and prognosis judgement for clinic.
【作者单位】：江苏省连云港市中医院南京中医药大学附属连云港医院;
【基金】：连云港市科技局科研项目(编号SH617)
【分类号】：R445.2;R743.3

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