三维准连续动脉自旋标记灌注成像对老年男性后循环缺血病灶的诊断价值

发布时间：2018-06-23 02:15

  本文选题：老年人 + 脑血流量　； 参考：《中国人民解放军医学院》2017年硕士论文

【摘要】：目的:利用3D-pCASL (3D-pseudocontinuous arterial spin labeling,三维准连续动脉自旋标记)技术探究80岁以上高龄老年男性脑血流灌注特点。材料与方法:对52例80岁以上无症状、无明确既往神经系统疾病的高龄老年男性进行磁共振常规扫描及3D-pCASL扫描,PLD时间(post labeling delay time,延迟标记时间)选取1525毫秒以及2525毫秒,利用SPM12软件分别测量左右大脑半球、前后循环rCBF(relative cerebral blood flow,相对脑血流量)值以及额叶、顶叶、颞叶、枕叶、基底节区、小脑的rCBF值。采用两独立样本t检验的统计学方法比较受试者左右大脑半球rCBF值的差异,前后循环rCBF值的差异,以及各个脑叶之间及基底节区rCBF值的差异。结果:52例受试者在PLD时间分别为1525ms及2525ms时,左侧大脑半球与右侧大脑半球相比,rCBF值差异均不具有统计学意义(p=0.259, p=0.630);在PLD时间为1525ms时,前循环的rCBF值高于后循环rCBF值,差异具有统计学意义(p=0.019),而在PLD时间为2525ms时,二者rCBF值差异不具有统计学意义(p=0.929);基底节区与其他脑叶相比,rCBF值低于各个脑叶,差异具有统计学意义(p=0.001,p=0.032,p=0.012,p=0.026, p=0.007),而除基底节区之外的脑叶间两两相比,rCBF值差异均不具有统计学意义。结论:3D-pCASL技术利用多个PLD时间探究老年人脑血流灌注的特点,并可以此为基础,更加准确的评价老年患者的异常脑血流灌注变化;3D-pCASL技术可作为评估老年人脑血流灌注的影像学指标,为临床诊断提供依据。目的:探究3D-pCASL技术对80岁以上老年人后循环缺血的研究价值,对老年人PCI(posterior circulation ischemia,后循环缺血)的临床诊断提供影像学依据。材料与方法:对80岁以上临床诊断为PCI的老年男性20例以及正常老年男性33例分别进行磁共振常规扫描及3D-pCASL扫描,PLD时间选取1525毫秒以及2525毫秒,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rCBF值。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rCBF的差异,病例组与对照组双侧枕叶、双侧小脑rCBF的差异,以及比较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rCBF增量(△rCBF)的差异。结果:病例组在PLD时间为1525ms及2525ms时,前循环的rCBF值均高于后循环rCBF值,而对照组仅在1525ms时前循环的rCBF值均高于后循环rCBF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rCBF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)。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时间来判断PCI的有无;3D-pCASL技术对检测后循环rCBF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 cerebral perfusion characteristics of aged men aged over 80 years by 3D-pCASL (3D pseudo continuous arterial spin labeling,) technique. Materials and methods: 1525 Ms and 2525 Ms were performed on 52 asymptomatic elderly men aged over 80 years without prior neurological diseases. The (post labeling delay time, delay time of PLD and 3D-pCASL scan were 1525 Ms and 2525 Ms, respectively. SPM12 software was used to measure the rCBF (relative cerebral blood flow, relative to cerebral blood flow in left and right cerebral hemispheres, and in frontal lobe, parietal lobe, temporal lobe, occipital lobe, basal ganglia region and cerebellum. The difference of rCBF between left and right cerebral hemispheres, the difference of rCBF between anterior and posterior circulation, and the difference of rCBF between different lobes and basal ganglia were compared by using two independent sample t test methods. Results there was no significant difference in rCBF between the left and right hemispheres when the 1525ms and 2525ms were 1525ms and 2525ms, respectively (p0.259, p0.630), and the rCBF of the anterior circulation was higher than that of the posterior circulation when the PLD-time was 1525ms, and there was no significant difference between the left hemisphere and the right hemisphere (p0.259, p0.630). The difference was statistically significant (p0. 019), but there was no significant difference in rCBF between the two groups (p0. 929), and the basal ganglia was lower than that in the other lobes (p 0. 929), and the RCBF of basal ganglia was lower than that of other lobes. The difference was statistically significant (p0. 001, p0. 032, p0. 012, p0. 026, p0. 007), but there was no significant difference in rCBF between the two lobes except the basal ganglia. Conclusion using multiple PLDs to explore the characteristics of cerebral blood perfusion in the elderly by using the technique of: 3D-pCASL, it can be used as a basis. The 3D-pCASL technique can be used as an imaging index to evaluate cerebral blood perfusion in elderly patients and provide evidence for clinical diagnosis. Objective: to explore the value of 3D-pCASL in the study of posterior circulation ischemia in elderly patients over 80 years old, and to provide imaging evidence for the clinical diagnosis of posterior circulation ischemia in elderly patients. Materials and methods: 1525 milliseconds and 2525 milliseconds were selected for conventional MRI scan and 3D-pCASL scan for 20 elderly men over 80 years old and 33 normal elderly men, respectively. The rCBF values of left occipital lobe, right occipital lobe, left cerebellum and right cerebellum were measured by SPM12 software. T test and rank sum test were used to compare the difference of rCBF between the two PLD groups before and after circulation, and between the case group and the control group in bilateral occipital lobe and cerebellar rCBF. The differences of rCBF increment (rCBF) in bilateral occipital lobe and cerebellum between two PLD time intervals were compared between the case group and the control group. Results: the rCBF values of the anterior circulation were higher than those of the posterior circulation when the PLD time was 1525ms and 2525ms, while in the control group, the rCBF value of the anterior circulation was higher than that of the posterior circulation only at the time of 1525ms. The rCBF values of both occipital lobes and cerebellum in the two PLD groups were significantly lower than those in the control group (p0. 003, p0. 002p0. 000 P0. 000, p0. 001, p0. 002, p0. 014), and the difference was statistically significant (p0. 003, p0. 000, p0. 001p0.000, p0. 001, p0. 002, p0. 014). Conclusion: the 3D-pCASL technique in the elderly with high age needs to use multiple PLD time to determine the sensitivity of PCI to detecting the decrease of rCBF, and it can be used as one of the early warning methods for post-circulatory stroke in the elderly.
【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】：2017
【分类号】：R743.3;R445.2

【参考文献】

相关期刊论文 前8条

1 库雷志;马明平;俞顺;郑雪萍;马小静;;DCE-MRI在肺癌不同病理类型的诊断价值[J];中国医学影像学杂志;2016年02期

2 郭琳佳;刘文宏;;后循环缺血的研究进展[J];中华老年心脑血管病杂志;2015年12期

3 沈君;;积极开展定量动态增强磁共振成像研究[J];磁共振成像;2015年08期

4 金红瑞;嵇鸣;叶春涛;;3.0T磁共振ASL技术在缺血性脑血管疾病中的应用研究[J];上海医学影像;2011年01期

5 庾建英;刘继新;朱沂;蒋杰;包国庆;;灌注加权成像和扩散加权成像对兔早期后循环缺血的对比分析[J];中国神经精神疾病杂志;2011年03期

6 王拥军;;适应与代偿[J];中国卒中杂志;2007年08期

7 李焰生;;中国后循环缺血的专家共识[J];中华内科杂志;2006年09期

8 高培毅,林燕;脑梗死前期脑局部低灌注的CT灌注成像表现及分期[J];中华放射学杂志;2003年10期

，

本文编号：2055294