三维准连续动脉自旋标记灌注成像对老年人后循环缺血病灶的诊断价值

发布时间：2018-06-13 15:36

本文选题：脑血流量 + 后循环缺血　；参考：《中国医学科学院学报》2017年02期

【摘要】：目的探究三维准连续动脉自旋标记灌注成像(3D-pCASL)对80岁以上老年人后循环缺血(PCI)的诊断价值,对老年人PCI的临床诊断提供影像学依据。方法对80岁以上临床诊断为PCI的老年男性患者20例以及正常老年男性33名分别进行磁共振常规扫描及3D-pCASL扫描,延迟标记时间(PLD)选取1525和2525 ms,利用SPM12软件分别测量其左侧枕叶、右侧枕叶、左侧小脑、右侧小脑脑血流量(CBF)。采用独立样本t检验及秩和检验比较在两个PLD时间病例组与对照组前后循环CBF的差异,病例组与对照组双侧枕叶、双侧小脑CBF的差异,以及病例组与对照组在两个PLD时间的时间间隔中双侧枕叶、双侧小脑CBF增量(△CBF)的差异。结果病例组在PLD时间为1525 ms及2525 ms时,前循环的CBF值均高于后循环CBF值,而对照组仅在1525 ms时前循环的CBF值均高于后循环CBF值,差异具有统计学意义(P=0.000,P=0.000,P=0.025);病例组在两个PLD时间时双侧枕叶、双侧小脑的CBF值均低于对照组,差异均具有统计学意义(P=0.003,P=0.002,P=0.000,P=0.001,P=0.000,P=0.001,P=0.002,P=0.014);与对照组相比,病例组在两个PLD时间的时间间隔中双侧枕叶、小脑△CBF均更小,差异均具有统计学意义(P=0.004,P=0.001,P=0.001,P=0.025)。结论高年龄段老年人因后循环血流慢,3D-pCASL技术需采用多个PLD时间判断PCI的有无;3D-pCASL技术对检测后循环CBF下降敏感,可作为老年人后循环卒中预警手段之一。
[Abstract]:Objective to investigate the diagnostic value of 3D quasi-continuous arterial spin-labeled perfusion imaging (3D-pCASL) for posterior circulation ischemia (PCI) in elderly patients over 80 years old, and to provide imaging basis for clinical diagnosis of PCI in elderly patients. Methods Twenty elderly men over 80 years old diagnosed as PCI and 33 normal elderly men were examined by conventional magnetic resonance imaging and 3D-pCASL respectively. 1525 and 2525 mswere selected for delayed labeling time. The left occipital lobe was measured by SPM12 software. Right occipital lobe, left cerebellum, right cerebellar blood flow (CBF). Independent sample t-test and rank sum test were used to compare the difference of circulating CBF between the two PLD time groups and control group, and the difference of CBF in both occipital lobes and cerebellum between case group and control group. The CBF increment (CBFs) of bilateral occipital lobe and cerebellum in the two PLD time intervals between the case group and the control group were also analyzed. Results when the PLD time was 1525 Ms and 2525 Ms, the CBF values of the anterior circulation were higher than those of the posterior circulation, while those of the control group were higher than those of the posterior circulation only at 1525 Ms. The CBF values of bilateral occipital lobes and cerebellum in the case group were all lower than those in the control group at the time of two PLD, and the differences were statistically significant (P 0.003, P 0.002 P0. 000 P0. 001P0. 000P0. 000P0. 001P0. 001P0. 002P0. 014). Compared with the control group, the bilateral occipital lobes were found in the two PLD time intervals. The CBF of cerebellum was smaller, and the difference was statistically significant (P = 0.004, P = 0.001, P = 0.001, P = 0.001, P = 0.025, P = 0.025). Conclusion the 3D-pCASL technique in elderly patients with high age needs to use multiple PLD time to judge whether PCI is available or not, which can be used as one of the early warning methods for post-circulatory stroke in the elderly.
【作者单位】：中国人民解放军总医院南楼放射科通用电气(北京)医疗系统集团磁共振事业部北京大学磁共振成像研究中心
【分类号】：R445.2;R743.3

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