磁敏感血管征定量参数对急性脑梗塞溶栓再通预测的初步研究
发布时间：2018-11-03 17:53
【摘要】：研究目的 评估磁敏感血管征及其幅度值、相位值对预测静脉内rt-PA溶栓治疗的急性脑梗塞患者的溶栓再通的意义。 方法 回顾性研究了28例MRA上存在颈内或大脑中动脉闭塞、并行静脉内rt-PA溶栓治疗的急性脑梗塞患者。根据溶栓前ESWAN上是否存在磁敏感血管征(susceptibility vessel sign, SVS)将患者分为SVS(+)与SVS(-)组,比较两组间临床及影像学特征。对SVS(+)的患者,在8个回波叠加后的幅度图上沿SVS边界作出感兴趣区(ROI),将此ROI对应到8回波叠加后的相位图及不同回波时间(TE)幅度图上,分别记录总的SVS及大脑中动脉M1段SVS(M1SVS)在TE=5ms与40ms幅度图上所对应的平均幅度值、及在叠加后相位图上的平均相位值。溶栓后24h内MRA上的血管再通情况根据心肌梗塞溶栓再通分级(Thrombolysis In Myocardial Infarction, TIMI)评定。比较再通组(TIMI≥2)组与无再通组间总的SVS及M1SVS的平均幅度值、相位值的差异,并分析这些测量值与溶栓后TIMI等级间的相关性。P0.05被认为具有统计学意义。 结果 SVS(+)组与SVS(-)组间,除溶栓前NIHSS评分及溶栓后1d时神经功能改善良好的患者所占比例外,其它临床、影像学特征,以及溶栓后血管再通情况无显著差异。SVS(+)的16例患者中,SVS在TE=5ms时图像上的平均幅度值与溶栓后再通等级存在负相关(rs=-0.652,P=0.006),溶栓再通的患者其平均幅度值低于无再通的患者(P=0.042)；其中M1SVS(+))的14例患者中,M1SVS在TE=5ms图像上的平均幅度值与溶栓后TIMI等级存在负相关(rs=-0.636,P=0.015)；M1SVS的平均相位值与溶栓后TIMI等级呈正相关(rs=0.622,P=0.017),再通组平均相位值高于无再通组(P=0.024)。SVS/Ml SVS在TE=40ms图像上的幅度值与溶栓再通等级无显著关系。溶栓前后均存在SVS的患者(n=8),其前后SVS的幅度值、相位值并无显著变化(P均＞0.05)。 结论 溶栓前是否存在SVS并不能帮助预测静脉溶栓的溶栓效果,但SVS/Ml SVS的平均幅度值、相位值与溶栓后血管再通等级相关,存在较低相位值与短回波时较高幅度信号的SVS的患者倾向于溶栓后血管无再通,对SVS的定量一定程度上可帮助预测静脉溶栓效果。
[Abstract]:Objective to evaluate the significance of magnetic sensitive vascular sign and its amplitude and phase value in predicting thrombolytic recanalization in patients with acute cerebral infarction treated with intravenous rt-PA thrombolytic therapy. Methods 28 cases of acute cerebral infarction with internal carotid or middle cerebral artery occlusion and intravenous rt-PA thrombolysis on MRA were retrospectively studied. The patients were divided into SVS () and SVS (-) groups according to the presence of magnetic sensitive vascular sign (susceptibility vessel sign, SVS) on ESWAN before thrombolysis. The clinical and imaging features of the two groups were compared. For the patients with SVS (), the region of interest (ROI),) was made along the boundary of SVS on the amplitude map of 8 echo stack. The ROI was corresponding to the phase map after 8 echo stacking and the (TE) amplitude map of different echo time. The mean amplitudes of total SVS and M1 segment SVS (M1SVS) of middle cerebral artery on TE=5ms and 40ms amplitudes were recorded respectively, and the average phase values on superimposed phase maps were also recorded. The vascular recanalization on MRA within 24 hours after thrombolysis was evaluated by (Thrombolysis In Myocardial Infarction, TIMI) classification of thrombolytic reperfusion in myocardial infarction. The average amplitude and phase of total SVS and M1SVS were compared between the recanalization group (TIMI 鈮，
本文编号：2308519
[Abstract]:Objective to evaluate the significance of magnetic sensitive vascular sign and its amplitude and phase value in predicting thrombolytic recanalization in patients with acute cerebral infarction treated with intravenous rt-PA thrombolytic therapy. Methods 28 cases of acute cerebral infarction with internal carotid or middle cerebral artery occlusion and intravenous rt-PA thrombolysis on MRA were retrospectively studied. The patients were divided into SVS () and SVS (-) groups according to the presence of magnetic sensitive vascular sign (susceptibility vessel sign, SVS) on ESWAN before thrombolysis. The clinical and imaging features of the two groups were compared. For the patients with SVS (), the region of interest (ROI),) was made along the boundary of SVS on the amplitude map of 8 echo stack. The ROI was corresponding to the phase map after 8 echo stacking and the (TE) amplitude map of different echo time. The mean amplitudes of total SVS and M1 segment SVS (M1SVS) of middle cerebral artery on TE=5ms and 40ms amplitudes were recorded respectively, and the average phase values on superimposed phase maps were also recorded. The vascular recanalization on MRA within 24 hours after thrombolysis was evaluated by (Thrombolysis In Myocardial Infarction, TIMI) classification of thrombolytic reperfusion in myocardial infarction. The average amplitude and phase of total SVS and M1SVS were compared between the recanalization group (TIMI 鈮，
本文编号：2308519
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