ASL在急性大面积缺血性脑卒中出血转化评估中的应用价值

发布时间：2018-02-22 16:45

本文关键词： 缺血性脑卒中出血转化动脉自旋标记　出处：《中风与神经疾病杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的探讨磁共振动脉自旋标记(ASL)成像在急性大面积缺血性脑卒中出血转化(HT)评估中的临床应用价值。方法回顾性分析2015年1月-2016年8月经临床和影像学证实的43例急性大面积缺血性脑卒中患者,采用GE3.0T超导MRI扫描仪进行常规序列、磁敏感(SWI)和ASL检查,通过软件后处理获取SWI最小密度投影及CBF伪彩图。通过观察MR检查结果,依据缺血梗死区不同灌注状态分为高、低灌注组,分析缺血梗死区不同灌注状态与HT的相关性;依据梗死核心区灌注状态分为高、低灌注组,分析梗死核心区灌注状态与HT类型之间的相关性。结果入组患者43例,其中缺血梗死区高灌注22例,发生HT 14例(63.64%);缺血梗死区低灌注21例,发生HT 5例(23.81%),HT与缺血梗死区灌注状态相关(P0.05)。梗死核心区高灌注8例,发生PH型HT 4例(50%),梗死核心区低灌注35例,发生PH型HT 3例(8.57%),梗死核心区高灌注与PH型HT发生有统计学意义(P0.05)。结论急性大面积脑梗死HT发生及类型与缺血梗死区灌注状态具有相关性,ASL检查可为临床提供HT评估信息,对于临床制定合理治疗方案及预后评估具有重要价值。
[Abstract]:Objective to evaluate the clinical value of magnetic resonance arterial spin labeling (ASL) imaging in the evaluation of acute large area ischemic stroke with hemorrhagic transformation. Methods 43 clinical and imaging confirmed cases from January 2015 to 2016 were retrospectively analyzed. Acute large area ischemic stroke, The GE3.0T superconducting MRI scanner was used to perform routine sequence, magnetic sensitive swi) and ASL examination. The minimum density projection of SWI and CBF pseudocolor images were obtained by software post-processing. The results of Mr examination were classified as high according to the different perfusion states of ischemic infarct area. In the low perfusion group, the correlation between the different perfusion states and HT in the ischemic infarct area was analyzed, and according to the perfusion status of the infarct core area, the relationship between the perfusion status of the infarct core area and the type of HT was analyzed, and the correlation between the perfusion state of the infarct core area and the type of HT was analyzed. Among them, 22 cases had hyperperfusion in ischemic infarction area, 14 cases had HT and 63.64% had HT, 21 cases had low perfusion in ischemic infarct area, 5 cases had HT and 5 cases had HT related to perfusion state of ischemic infarct area, 8 cases had hyperperfusion in core area of infarction. PH type HT was found in 4 cases and hypoperfusion in the infarct core in 35 cases. There were significant differences between hyperperfusion and PH type HT in the infarct core area. Conclusion there is a correlation between the occurrence and type of HT in acute large area cerebral infarction and the perfusion status of ischemic infarction area. ASL examination can provide information for the evaluation of HT in clinic. It is of great value for clinical rational treatment and prognosis evaluation.
【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】：R743.3;R816.1

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