磁共振三维动脉自旋标记技术在短暂性脑缺血发作中的初步应用研究

发布时间：2018-04-19 18:21

本文选题：动脉自旋标记 + 脑灌注　；参考：《中国人民解放军医学院》2014年硕士论文

【摘要】：第一部分磁共振三维动脉自旋标记技术在正常成人脑部应用的可重复性研究目的:研究磁共振三维动脉自旋标记技术（there dimensional pseudo-continuousarterial spin labeling,3D ASL）应用于正常成人全脑血流灌注成像的可重复性。材料与方法:对8例健康成年人进行脑部3D ASL序列及3D结构像扫描，间隔一周后同一时间再次进行扫描，对两次采集的ASL数据采用基于体素的组内相关系数（intraclass correlation coefficient, ICC）分析。结果: ICC值为0.4-1的脑区主要位于双侧额叶及颞叶灰质及白质、双侧顶叶及枕叶白质、双侧小脑半球及脑干。结论:3D ASL可重复性好，是一个可靠的评估脑灌注的序列。第二部分磁共振三维动脉自旋标记技术在评价短暂性脑缺血发作患者脑血流灌注中的初步应用目的：探讨磁共振三维动脉自旋标记技术（3D ASL）脑灌注成像在评价短暂性脑缺血发作（transient ischemic attack, TIA)患者脑血流灌注中的应用价值。材料与方法：对18例TIA患者及22例健康志愿者进行常规MRI、脑结构像扫描和3D ASL（PLD1525ms、2025ms、2525ms）全脑灌注成像。采用基于体素分析(voxel-basedanalysis,VBA)的方法对脑血流图（cerebral blood flow,CBF）进行分析，评价不同PLD时间对脑灌注异常的检出效能。结果：与健康对照（health control, HC）组比，TIA组患者存在CBF减低脑区。不同PLD（PLD1525ms、2025ms、2525ms）时间CBF减低区域数量及大小分别为18个激活簇（1390个体素）、24个激活簇（728个体素）及10个激活簇（73个体素）。 ROC曲线分析结果显示PLD1525ms检查方案的敏感性和特异性最高。结论：3D ASL全脑容积灌注成像技术能够敏感检出TIA患者脑部灌注异常改变，不同PLD时间对脑灌注异常的检出有一定影响。第三部分磁共振三维动脉自旋标记技术与动态磁敏感对比灌注成像在短暂性脑缺血发作中的对比研究目的：对比研究磁共振三维动脉自旋标记技术（there dimensional pseudo-continuousarterial spin labeling,3D ASL）与动态磁敏感对比灌注成像（dynamic susceptibilitycontrast-perfusion weighted imaging，DSC-PWI)在评价短暂性脑缺血发作（transientischemic attack)中的应用价值。材料与方法：对10例TIA患者进行常规MRI、脑结构像扫描和3D ASL全脑灌注成像， PLD选择1525ms、2025ms、2525ms，同时进行DSC灌注成像。视觉评定2种灌注技术的异常表现，并测量脑血流（cerebralblood flow, CBF）减低区域CBF值及对侧正常镜像区域CBF值，计算rCBF比值。结果:定性分析显示10例患者中，2种技术检查8例结果一致(灌注异常6例，正常灌注2例)，2例不一致，其中4例ASL显示延迟灌注不足而DSC-PWI显示正常。定量分析灌注异常区与对照侧CBF/rCBF比值，经配对资料的t检验，，两种方法间差异无统计学意义(P0．05)。结论：3D ASL与DSC-PWI两种灌注方法对判断TIA患者的血流灌注情况具有一致性。3DASL可定量分析全脑血流灌注情况，作为一种无创的影像学检查方法对TIA的血流动力学研究有重要价值。
[Abstract]:Part one: reproducibility of three-dimensional magnetic resonance spin labeling in normal adult brain.
Objective: To study the reproducibility of there dimensional pseudo-continuousarterial spin labeling (3D ASL) in normal adult whole brain perfusion imaging. Materials and methods: the brain 3D ASL sequence and 3D structural image scan were carried out in 8 healthy adults, and one week after the same time was reentered at the same time. The two ASL data were analyzed by intraclass correlation coefficient (ICC) based on voxel. Results: the brain region with ICC value of 0.4-1 was mainly located in the bilateral frontal lobe and temporal lobe gray matter and white matter, bilateral parietal lobe and occipital white matter, bilateral small hemisphere and brain stem. Conclusion: 3D ASL reproducibility is good, it is one A reliable evaluation of the sequence of cerebral perfusion.
The second part is the preliminary application of three-dimensional arterial spin labeling technique in evaluating cerebral blood perfusion in patients with transient ischemic attack.
Objective: To explore the value of 3D ASL perfusion imaging (3D ASL) in the evaluation of cerebral blood flow in patients with transient ischemic attack (transient ischemic attack, TIA). Materials and methods: 18 cases of TIA patients and 22 healthy volunteers were treated with conventional MRI, brain structure scan and 3D ASL (PLD1525ms, 2025m). S, 2525ms) whole brain perfusion imaging. The method of voxel-basedanalysis (VBA) was used to analyze the cerebral blood flow chart (cerebral blood flow, CBF) and evaluate the detection efficiency of different PLD time to cerebral perfusion abnormality. The 2025ms, 2525ms) time CBF reduction area and size were 18 activation clusters (1390 individual elements), 24 activation clusters (728 individual elements) and 10 activation clusters (73 individual elements). The ROC curve analysis showed that the sensitivity and specificity of the PLD1525ms examination scheme were the highest. Conclusion: 3D ASL whole brain perfusion imaging technique can be sensitive to the detection of TIA patients. Abnormal brain perfusion changes, and different PLD time had a certain effect on the detection of cerebral perfusion abnormalities.
The third part is a comparative study of three dimensional arterial spin labeling technique and dynamic susceptibility contrast perfusion imaging in transient ischemic attack.
Objective: To compare the evaluation of there dimensional pseudo-continuousarterial spin labeling (3D ASL) and dynamic magnetic susceptibility contrast perfusion imaging (dynamic susceptibilitycontrast-perfusion weighted imaging, DSC-PWI) in the evaluation of short temporary ischemic attacks. Value. Materials and methods: 10 patients with TIA were performed routine MRI, brain structure scan and 3D ASL perfusion imaging, PLD selected 1525ms, 2025ms, 2525ms, and DSC perfusion imaging. The abnormal manifestations of the 2 perfusion techniques were evaluated by vision, and the regional cerebral blood flow (cerebralblood flow, CBF) decreased and the contralateral normal image region was measured. BF value and calculated the ratio of rCBF. Results: of the qualitative analysis, 2 of the 10 patients showed the same results in 8 cases (6 cases of perfusion abnormality, 2 cases of normal perfusion) and 2 cases, of which 4 cases of ASL showed delayed perfusion and DSC-PWI showed normal. Quantitative analysis of abnormal perfusion area and CBF/rCBF ratio, t test of paired data, two methods There is no statistical significance (P0.05). Conclusion: the two perfusion methods of 3D ASL and DSC-PWI have a consistent.3DASL to determine the blood flow perfusion in TIA patients. As a noninvasive method of imaging examination, it is of great value to study the hemodynamic study of TIA.

【学位授予单位】：中国人民解放军医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R743.31

【参考文献】