三维动脉自旋标记评价静脉溶栓治疗急性脑梗死疗效的价值

发布时间：2018-01-31 14:44

本文关键词： 急性脑梗死动脉自旋标记静脉溶栓扩散加权成像　出处：《临床放射学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的探讨三维动脉自旋标记(3D-ASL)评价静脉溶栓治疗急性脑梗死疗效的价值。方法回顾性分析急性脑梗死静脉溶栓治疗的32例患者资料,治疗前、治疗7天后均行扩散加权成像(DWI)及3D-ASL检查,测量病灶在DWI序列呈高信号区域的相对脑血流量(r CBF),并用美国国立卫生研究院卒中量表(NIHSS)评分评估疗效,采用配对t检验比较治疗前后DWI高信号灶内的r CBF的差异,用方差分析ASL/DWI不同匹配组治疗前后NIHSS评分的差异,采用Spearman等级相关分析ASL/DWI不同匹配(ASLDWI、ASL=DWI、ASLDWI)与静脉溶栓效果的关系。结果 ASLDWI组19例、ASL=DWI组10例、ASLDWI组3例。ASL/DWI不同匹配的急性脑梗死在DWI高信号灶内的r CBF较静脉溶栓前均升高,差异有统计学意义(t=5.091,P0.05)。ASLDWI、ASL=DWI组治疗后NIHSS评分比治疗前降低,差异有统计学意义(t=10.363,P0.001;t=8.392,P0.001),而ASLDWI组治疗前后NIHSS评分的差异无统计学意义(t=1.001,P=0.423)。Spearman等级相关分析显示,ASL/DWI不同匹配与静脉溶栓效果呈正相关(r=0.798,P0.001)。结论 3D-ASL对评价急性脑梗死的静脉溶栓疗效有重要的价值。
[Abstract]:Objective to evaluate the efficacy of intravenous thrombolysis in the treatment of acute cerebral infarction (ACI) by 3D arterial spin labeling (3D-ASL). Methods the data of 32 patients with acute cerebral infarction treated with intravenous thrombolytic therapy were retrospectively analyzed. Diffusion weighted imaging (DWI) and 3D-ASL were performed after 7 days of treatment. The relative cerebral blood flow (CBF) was measured in the hyperintense region of DWI sequence. The efficacy was evaluated with the National Institutes of Health Stroke scale (NIHSS) score and the difference of r CBF in DWI hyperintense foci before and after treatment was compared by paired t test. The difference of NIHSS score before and after treatment in different matching group of ASL/DWI was analyzed by ANOVA. Spearman grade correlation was used to analyze the difference of NIHSS score in different matching groups of ASL/DWI before and after treatment. Results there were 19 cases in ASLDWI group and 10 cases in ASL DWI group. R CBF in 3 patients with acute cerebral infarction with different matching on ASL / DWI in ASLDWI group was significantly higher than that before intravenous thrombolytic therapy, and the difference was statistically significant (P < 0.05). After treatment, the NIHSS score in the P0.05U. ASLDWII-ASL DWI group was lower than that before treatment, and the difference was statistically significant (P 0.001). The difference of NIHSS score before and after treatment in ASLDWI group was not statistically significant. Spearman grade correlation analysis showed that different matching of ASL / DWI had positive correlation with intravenous thrombolytic effect (P < 0. 798). Conclusion 3D-ASL has important value in evaluating the efficacy of intravenous thrombolytic therapy in acute cerebral infarction.
【作者单位】：暨南大学附属江门中医院医学影像科;
【基金】：江门市科技计划资助项目(编号:201610029)
【分类号】：R445.2;R743.33
【正文快照】： 磁共振三维动脉自旋标记(3D-ASL)与扩散加权成像(DWI)检查已广泛应用于急性脑梗死的诊断[1],用ASL/DWI不同匹配指导临床静脉溶栓治疗急性脑梗死鲜有报道。本研究对静脉溶栓前后的急性脑梗死患者进行3D-ASL、DWI检查,测量急性脑梗死DWI高信号灶内的相对脑血流量(r CBF),探讨ASL

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