三维动脉自旋标记在缺血性脑血管病中的应用研究

发布时间：2018-11-03 19:38

【摘要】：目的:评价三维动脉自旋标记(3D-ASL)在缺血性脑血管病中的应用价值。方法:纳入本研究的缺血性脑血管病患者30例,其中急性脑梗死13例,短暂性脑缺血发作(TIA)17例。所有研究对象均行常规MRI、DWI及3D-ASL扫描。观察并分析所有患者的DWI及ASL全脑血流量(ASL-CBF)图有无异常。选择13例脑梗死患者的梗死最大层面,采用手动勾画法分别在DWI、ASL-CBF图上测量梗死面积和灌注异常面积,采用两独立样本t检验比较两者间的差异。结果:17例TIA在DWI图上均无阳性发现,12例在ASL-CBF图上表现为大小不等灌注减低区。2例TIA复查时可见ASL-CBF图上血流灌注部分恢复。13例脑梗死的DWI图上见大小不等的高信号,梗死面积为(1026.54±295.50)mm2,ASL-CBF图上灌注异常面积为(2901.77±415.94)mm2,并可观察到高、低灌注状态。ASL-CBF图上灌注异常面积大于DWI图上梗死面积,且差异有统计学意义(t=3.675,P=0.001)。结论:3D-ASL可全面反映缺血性脑血管病的血流灌注状态,动态观察血流灌注恢复情况,有利于及时指导临床治疗并判断预后。
[Abstract]:Objective: to evaluate the value of three-dimensional arterial spin labeling (3D-ASL) in ischemic cerebrovascular disease. Methods: thirty patients with ischemic cerebrovascular disease were included in this study, including 13 patients with acute cerebral infarction and 17 patients with transient ischemic attack of (TIA). All subjects were scanned by routine MRI,DWI and 3D-ASL. To observe and analyze the abnormality of DWI and ASL global cerebral blood flow (ASL-CBF) in all patients. In 13 patients with cerebral infarction, the infarct size and perfusion abnormal area were measured by manual drawing method on DWI,ASL-CBF, and the difference between them was compared by two independent samples t test. Results: none of the 17 cases of TIA was found on DWI. On ASL-CBF, 12 cases showed decreased perfusion area of different size, 2 cases showed partial recovery of blood perfusion on ASL-CBF map on TIA reexamination, and 13 cases of cerebral infarction showed hyperintensity of different size on DWI graph, infarct area was (1026.54 卤295.50) mm2,. The area of abnormal perfusion on ASL-CBF was (2901.77 卤415.94) mm2, and the high and low perfusion status was observed. The area of abnormal perfusion on ASL-CBF was larger than that on DWI, and the difference was statistically significant (t = 3.675). Conclusion: 3D-ASL can reflect the blood perfusion state of ischemic cerebrovascular disease and observe the blood perfusion recovery dynamically, which is helpful to guide the clinical treatment and judge the prognosis in time.
【作者单位】：华中科技大学同济医学院附属同济医院放射科;
【基金】：国家自然科学基金(81171308) 国家“十二五”科技支撑计划项目(2011BAI08B10)
【分类号】：R743.3;R445.2

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