摘要
目的探讨三维动脉自旋标记(three-dimensional arterial spin labeling,3D ASL)磁共振脑灌注成像技术在评价急性脑梗死溶栓疗效中的应用价值。材料与方法搜集急诊溶栓治疗的20例急性脑梗死患者,所有患者均于溶栓前发病10 h内行常规MRI平扫、扩散加权成像(diffusion weighted imaging,DWI)和3D ASL检查,溶栓后1~7 d复查常规MRI平扫、DWI和3D ASL检查。测量溶栓术前及术后脑梗死区与正常对照区的脑血流量(cerebral blood flow,CBF)值。结果 20例急性期脑梗死患者DWI检查均可见弥散受限高信号区,表现为表观扩散系数(apparent diffusion coefficient,ADC)值降低;3D ASL检查均发现与临床症状对应的脑组织低灌注区,表现为CBF值降低。ASL显示低灌注区域的体积均较DWI显示范围大。溶栓术后18例低灌注区范围不同程度缩小,2例低灌注区扩大,10例出现局部高灌注改变。统计学分析结果显示溶栓治疗后多数患者脑灌注情况明显改善,缺血区CBF均与溶栓前差异有统计学意义(P<0.05)。结论作为一项无创性磁共振灌注成像新技术,3D ASL能够显示脑梗死溶栓术后低灌注向高灌注的转换,为评价急性脑梗死患者的溶栓疗效提供重要依据。
Objective To evaluate the value of 3D whole-brain pseudo-continuous arterial spin labeling imaging （3D ASL） in evaluationg the thrombolytic therapy in patients with acute cerebral infarction. Materials and Methods： Conventional plain MRI, diffusion weighted imaging （DWI） and 3D ASL were performed on 20 patients with acute cerebral infarction within 10 hours after onset of symptom. All patients were reexamined cerebral plain MRI, DWI and 3D ASL after thrombolysis between 1-7 day. Cerebral blood fow （CBF） of infarction area and normal control area was carried out on 3D ASL images before and after thrombolytic therapy. Results： All 20 cases showed early infaction signs on DWI with ADC decreased and hypoperfusion on 3D ASL with CBF decreased corresponding to clinical symptoms. The abnormal area was larger on 3D ASL than DWI. Follow-up 3D ASL showed that after thrombolysis 18 cases with samller hypoperfusion, 2 cases with larger hypoperfusion and 10 cases with hyperferfusion. There was statisticaly significant difference between the CBF on ischemic region before and after thrombolysis （P〈0.05）. Conclusions： As a new noninvasive perfusion imaging technique, 3D ASL can depict detailed hemodynamic information before and afer thrombolysis, and provide important basis for evaluating the effect of thrombolytic therapy in patients with acute cerebral infarction.
作者
刘娜
李道伟
马强
何丹
LIU Na;LI Dao-wei;MA Qiang;HE Dan(Department of Radioloy, the People＇s Hospital of Liaoning Province, Shenyang 110016, China)
出处
《磁共振成像》
CAS
CSCD
2017年第11期807-811,共5页
Chinese Journal of Magnetic Resonance Imaging
基金
辽宁省自然科学基金(编号:201602427)~~
关键词
磁共振成像
急性脑梗死
溶栓
灌注成像
Magnetic resonance imaging
Acute cerebral infarction
Thrombolysis
Perfusion imaging
