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]:Methods 40 healthy volunteers were divided into groups A , B , C and D4 by magnetic resonance arterial spin labeling technique . There was no significant difference in CBF between males and females ( P > 0.05 ) .

The application value of the second part in ischemic cerebrovascular disease

Objective To investigate the diagnostic value of magnetic resonance arterial spin labeling ( MRI ) in ischemic cerebrovascular disease .

Methods Thirty - five patients with acute cerebral infarction were diagnosed as acute cerebral infarction ( 6 - 72 hours ) and 10 cases were diagnosed as TIA patients . All the patients were examined by conventional MRI and MRI .

Results In 10 patients with acute cerebral infarction , the positive rate of DWI was 100 % .
All 15 patients with small area acute cerebral infarction and DWI were positive . The results showed that there were 11 cases of cerebral infarction in the corresponding regions , and the coincidence rate was 73 . 3 % . All of the 10 patients with TIA were negative , and 8 cases showed different degree of perfusion defect , and MRA showed the arteries with different degrees of arteriosclerosis or stenosis .

Conclusion As a non - invasive perfusion imaging method , there is a significant diagnostic advantage for ischemic cerebrovascular disease , which is expected to replace invasive technique in the assessment 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

【共引文献】