三维动脉自旋标记成像在缺血性脑梗死患者中的应用研究

Application of three-dimensional arterial spin label imaging in patients with acute ischemic cerebral infarction

摘要:

分析磁共振三维动脉自旋标记成像（3D-ASL）在急性缺血性脑梗死患者中的应用价值。方法22 例缺血性脑梗死患者行常规MRI序列、DWI、MRA、3D-ASL检查。采集原始数据上传至ADW 4.2工作站，采用Func-tool软件处理，获取灌注参数的伪彩图。观察脑梗死患者的ASL-CBF、DWI图像并分别测量异常灌注面积及梗死面积，分别用Excel 表格记录DWI 及ASL 所测数值，统计数值均以均数±标准差 （x±s）表示，采用两独立样本检验比较两者间的差异；观察MRA 梗死区周围的脑血管有无狭窄及闭塞。结果22 例患者中19 例ASL 显示不同程度灌注异常，19 例灌注异常患者的异常灌注部位均与DWI 梗死灶一致，ASL-CBF 图上灌注异常面积为（17.10±6.15）cm2，DWI 梗死面积为（13.54±4.97）cm2，ASL-CBF 图上灌注异常面积大于DWI 图上梗死面积，且差异有统计学意义（ p=0.029）。结论3D-ASL在临床应用中能够较可靠地反映缺血性脑梗死患者的低灌注状态，结合MRA及DWI更有利于指导临床诊疗。

Abstract:

To analyze the application value of magnetic resonance imaging (MRI) of 3D arterial spin labeling (3D-ASL) in patients with acute ischemic cerebral infarction. Methods Routine MRI with DWI, magnetic resonance angiography (MRA) and 3D-ASL scan were performed in 22 patients with ischemic stroke. The original data were recorded and uploaded to ADW 4.2 workstation, the pcolor of the perfusion parameters was obtained. The ASL-CBF and DWI images of the cerebral infarction patients were observed, and the perfusion area and infarct size were measured. DWI and ASL values were recorded in Excel spreadsheets, and expressed as mean ±standard deviation (x ±s). Independent-sample test was used to compared the differences. The cerebral vessels around MRA infarction area were observed. Results Of the 22 cases, 19 patients showed abnormal perfusion on the ASL map (16 cases with hypoperfusion, 2 cases with hyperperfusion, 1 case with high perfusion and low perfusion at the same time). Their abnormal perfusion sites were consistent with the infarction sites on DWI. The abnormal perfusion area in the ASL-CBF map was significantly larger than the DWI infarction area [(17.10 ±6.15) cm2 vs (13.54 ±4.97) cm2,p= 0.029]. Conclusions 3D-ASL can reflect the low perfusion state of the patients with cerebral infarction in clinical application, and DWI and MRA are more helpful for clinical diagnosis and treatment.