ASL在缺血性脑血管病中的应用研究价值

发布时间：2018-06-05 02:00

本文选题：动脉自旋标记 + 脑血流量　；参考：《上海交通大学》2014年硕士论文

【摘要】：第一部分ASL在不同年龄段正常人脑血流量中的应用目的利用磁共振动脉自旋标记技术（Arterial Spin Labeling，，ASL）测量正常人脑血流量（Cerebral Brain Flow，CBF），并探讨CBF值与年龄及性别的关系。方法将40名健康志愿者按年龄分成A、B、C、D4组，接受常规MRI和ASL序列（Q2TIPS）检查。经图像后处理得到CBF图，选取ROI测量双侧大脑半球的CBF值，比较左右半球的差异，并分析CBF值与年龄、性别的关系。结果各年龄组脑白质、灰质及全脑CBF值在左右半球差异无统计学意义（P均＞0.05）。仅C组左侧全脑CBF值与年龄呈正相关（r=0.378，P=0.020）。但各年龄组间双侧大脑半球灰、白质及全脑CBF值差异无统计学意义（P均＞0.05）。男性与女性CBF值对比差异无统计学意义（P均＞0.05）。结论研究肯定了ASL技术的临床应用价值。初步的研究结果认为，CBF值与年龄及性别并无明显相关性。第二部分ASL在缺血性脑血管病中的应用价值目的利用磁共振动脉自旋标记技术（ASL）在缺血性脑血管病中的应用，探讨ASL在缺血性脑血管病中的诊断价值。方法选取35例临床诊断或高度怀疑为缺血性脑血管病的患者，其中25例患者临床诊断为急性脑梗死（6-72小时），10例临床诊断为TIA患者。所有患者均行常规MRI、ASL及脑血管成像（magnetic resonance angiography，MRA）检查。5例大面积急性脑梗死患者加扫DSC，经图像后处理得到ASL-CBF图及DSC-PWI图。对比分析各种磁共振功能成像技术在缺血性脑血管病的影像表现，探讨ASL对缺血性脑血管病的诊断优势。结果10例大面积急性脑梗死，DWI阳性显示率为100%，ASL-CBF图均可见相应区域灌注减低区；15例小面积急性脑梗死，DWI均显示为阳性，ASL-CBF图显示相应区域灌注减低区11例，两者符合率73.3%。MRA均显示相应供血血管的闭塞或不同程度的狭窄。10例TIA患者DWI均为阴性，8例ASL-CBF图表现为不同程度的灌注缺损，MRA显示相应供血血管不同程度的动脉硬化或狭窄。结论作为一种非侵袭性的灌注成像方法，ASL对缺血性脑血管病具有明显的诊断优势，有望将来取代侵袭性检查技术在脑血流灌注评估方面的地位。
[Abstract]:Part I Application of ASL in normal human brain blood flow in different age groups objective to measure normal human brain blood flow (ASL) by magnetic resonance arterial spin labeling technique (ASL), and to explore the relationship between CBF value and age and sex. Methods 40 healthy volunteers were divided into four groups according to their age. Routine MRI and ASL sequence Q2TIPSwere performed. After image processing, CBF map was obtained, and ROI was selected to measure the CBF value of bilateral cerebral hemispheres. The difference between the left and right hemispheres was compared, and the relationship between CBF value and age and sex was analyzed. Results the CBF values of white matter, gray matter and whole brain in all age groups had no significant difference in left and right hemispheres (P > 0.05). In group C, there was a positive correlation between the CBF value of the left whole brain and age. However, there was no significant difference in CBF values of gray, white matter and whole brain between different age groups (P > 0.05). There was no significant difference in CBF between male and female (P > 0.05). Conclusion the study confirmed the clinical application value of ASL technique. The preliminary results showed that there was no significant correlation between CBF and age and sex. Application value of ASL in Ischemic Cerebrovascular Disease Objective to evaluate the diagnostic value of ASL in ischemic cerebrovascular disease (ICVD) by using magnetic resonance arterial spin labeling (ASL) technique. Methods 35 patients with ischemic cerebrovascular disease were selected, 25 of whom were diagnosed as acute cerebral infarction for 6 to 72 hours and 10 were diagnosed as TIA. All the patients were examined by routine MRII-ASL and magnetic resonance angiography (MRAA). The ASL-CBF and DSC-PWI images were obtained by image post-processing in 5 patients with large area acute cerebral infarction. The imaging features of various magnetic resonance functional imaging techniques in ischemic cerebrovascular disease were analyzed and the diagnostic advantages of ASL in ischemic cerebrovascular disease were discussed. Results the positive rate of DWI in 10 patients with large area acute cerebral infarction was 100%. All the 15 patients with small area acute cerebral infarction showed decreased area of perfusion on DWI. All the 15 cases of small area of acute cerebral infarction were positive on DWI, and 11 cases showed the corresponding area of decreased perfusion on ASL-CBF images. The coincidence rate of both 73.3%.MRA was that the corresponding blood supply vessel was occluded or stenosed in different degree. DWI was negative in 8 patients with TIA and showed different degree of arteriosclerosis or stenosis in different degree of perfusion defect. Conclusion as a noninvasive perfusion imaging method, ASL has obvious advantages in the diagnosis of ischemic cerebrovascular disease, and it is expected to replace the invasive technique in the evaluation of cerebral blood flow perfusion.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743;R445.2

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