摘要
目的 探讨全脑容积灌注动脉自旋标记成像（3DASL）应用于缺血性脑血管病诊断中的可行性和价值.方法 实验1：全部患者（对照组30例、脑栓塞组20例）行头部MRI增强检查,加扫3DASL及动态磁敏感对比增强（DSC）序列.对照组计算3DASL及DSC得到的大脑左右半球半卵圆中心镜像感兴趣区（ROI）的脑血流量（CBF）比,脑栓塞组计算2种方法得到的病灶区域与对侧镜像ROI的CBF比,配对分析数据.实验2：急性及亚急性脑栓塞组和短暂脑缺血发作（TIA）组患者各30例,全部行常规头部MRI检查,加扫3DASL序列,对比分析弥散成像（DWI）及3DASL 2种技术显示病变的阳性率及面积大小.结果 实验1：2种灌注方法获得了一致的灌注结果.对照组左右侧镜像ROI的CBF比值：3DASL为1.02±0.18,DSC为1.06±0.24,2者间差异无统计学意义（P＞0.05）;脑栓塞组病灶区域与对侧镜像ROI的CBF比值：3DASL为0.50±0.12,DSC为0.48±0.18,2者间差异无统计学意义（P＞0.05）.实验2：急性及亚急性脑栓塞的检出率：DWI和3DASL均为100％.同一病例相同病变显示面积的大小：SDwI＜S3DASL,n=22; SDW1≈S3DASL,n=8;SDWI＞S3DASL,n=0.TIA的检出率：DWI为0％,3DASL为70％.结论 3DASL和DSC相比,测量脑血流量有相似的敏感性,且具有三维成像扫描范围广、无需注射对比剂和可重复性强等优势.3DASL较DWI有更高的TIA阳性检出率,有助于TIA的早期诊断,全面准确地评估缺血半暗带及急性缺血性脑血管病的血流灌注情况,可作为急诊检查方法之一,为临床治疗提供科学依据.
Objective To investigate the feasibility and clinical application value of 3D arterial spin labeling （3DASL） technique in diagnosis of ischemic cerebrovascular disease.Methods Experiment 1：Controlgroup （n=30） and brain infarction group （n=20） were established.All patients were routinely examined including 3DASL and dynamic susceptibility contrast （DSC） enhanced series.The analysis of the control group was performed using signal intensity measurement in three paired regions of interest （ROI） which were selected in left hemisphere centrum semiovale and the opposite hemisphere mirror regions respectively.The ROIs of brain infarction group were selected in the lesion areas and their mirror region.The cerebral blood flow （CBF） of each ROI was measured with 3DASL and DSC respectively.The CBF ratio to each ROI and its mirror ROI were calculated.Data were compared using paired-t test.Experiment 2：Acute cerebral infarction （n=30） and transient ischemic attack （TIA） group （n=30） were established.All patients were routinely examined including 3DASL and diffusion weighted imaging （DWI）.The positive rate and the area of the lesions were calculated respectively with 3DASL and DWI and compared.Results Experiment 1：Both the control and brain infarction group demonstrated agreement between 3DASL and DSC.The CBF ratios of the control group were 1.02±0.18 and 1.06±0.24 respectively and revealed no statistically significant between that of 3DASL and DSC （P＞0.05）.The CBF ratios of brain infarction group were 0.50±0.12 and 0.48±0.18 respectively,and also revealed no statistically significant between two methods （P＞0.05）.Experiment 2：The positive rate of acute cerebral infarction were 100％ with both DWI and 3DASL.The areas of the lesion detected by both methods were：SDwI＜S3DASL,n=22; SDWI ≈-S3DASL,n=8; SDWI＞S3DASL,n=0.The positive rate of TIA by DWI was 0％,and 70％ by 3DASL.Conclusion The noninvasive,safe and repeatable 3DASL technique is almost as sensitive as DSC in the measurement of CBF.However,and it is more sensitive than DWI in diagnosis of TIA.Combining 3DASL and DWI will be helpful in early diagnosis of TIA,finding ischemic penumbra and estimating the blood perfusion of ischemic cerebrovascular disease.
出处
《国际生物医学工程杂志》
CAS
2013年第6期344-347,I0008,共5页
International Journal of Biomedical Engineering
作者简介
通信作者：李锋坦，Email：left9999@sina．com
