动脉内穿行伪影对急性脑梗死灌注评估的临床应用价值

发布时间：2018-04-01 17:20

本文选题：急性脑梗死　切入点：动脉自旋标记　出处：《实用医学杂志》2017年07期

【摘要】：目的:探讨磁共振动脉自旋标记(ASL)成像所示动脉内穿行伪影(ATA)在急性脑梗死灌注状态及近期预后评估中的临床应用价值。方法:搜集2014年12月至2016年4月经临床和影像学证实的40例急性期脑梗死患者,均采用GE 3.0T超导MRI扫描仪行常规序列和三维伪连续式动脉自旋标记(3D-PCASL)成像检查,通过观察脑血流量(CBF)伪彩图提示梗死核心区周围是否出现匍匐走行条状高灌注信号,将40例患者分为ATA组和对照组,分别对两组患者入院当日与入院后15 d行美国国立卫生研究院卒中量表(NIHSS)评分并进行分析比较。结果:两组患者入院检查当日NIHSS评分差异无统计学意义(P0.05)。ATA组患者入院当日与入院后15 d NIHSS评分好转、稳定及进展比分别为14/18、3/18、1/18;对照组患者入院当日与入院后15 d临床NIHSS评分好转、稳定及进展比分别为分别是7/22、5/22、10/22,两组入院后15 d NIHSS评分差异有统计学意义(P0.05)。结论:通过观察CBF伪彩图显示梗死核心区周围是否存在ATA,反映缺血梗死区血流灌注状态,能为临床评估急性期缺血性脑卒中患者病情现状及近期预后提供客观依据。
[Abstract]:Objective: to evaluate the clinical value of intraarterial translocation of Arterial artifact (ATAA) on magnetic resonance arterial spin labeling (ASL) imaging in the evaluation of perfusion status and short-term prognosis of acute cerebral infarction. Methods: clinical data from December 2014 to April 2016 were collected. And 40 patients with acute cerebral infarction confirmed by imaging, GE 3.0T superconducting MRI scanner was used for routine sequence and 3D pseudo-continuous arterial spin-labeled 3D-PCASL imaging. The observation of cerebral blood flow (CBF) pseudochromogram indicated whether there were creeping stripe hyperperfusion signals around the infarct core area. Forty patients were divided into ATA group and control group. The NIHSS scores of the two groups on admission and 15 days after admission were analyzed and compared. Results: there was no significant difference in NIHSS scores between the two groups on admission examination. The NIHSS score was improved on the day of admission and 15 days after admission. The stable and progressive ratios were 14 / 18 / 18 / 18 / 18 respectively. The clinical NIHSS scores of the control group were improved on the admission day and 15 days after admission. The stable and progressive ratios were 7 / 22 / 22 / 22 / 10 / 22, respectively. There was a statistically significant difference in NIHSS scores between the two groups 15 days after admission (P 0.05). Conclusion: by observing CBF pseudochromogram to show whether there is ATAs around the core area of the infarct, it can reflect the blood flow perfusion status in the ischemic infarct area. It can provide an objective basis for clinical evaluation of the present condition and short-term prognosis of patients with acute ischemic stroke.
【作者单位】：南京中医药大学连云港附属医院放射科;南京中医药大学连云港附属医院脑病科;
【分类号】：R445.2;R743.33

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