磁共振3D-pcASL灌注成像结合DWI鉴别超急性与急性缺血性脑梗死
Journal of Medical Imaging(2017)
Abstract
目的 探讨磁共振三维伪连续动脉自旋标记(3 D-pcASL)灌注成像联合DWI序列鉴别超急性与急性缺血性脑梗死的临床应用价值.方法 回顾分析我院20例超急性期(A组)和36例急性期(B组)缺血性脑梗死患者的MRI图像.在梗死最大层面测量3D-pcASL序列脑血流(CBF)的异常灌注面积(SCBF)和DWI图上异常高信号面积(SDWI),并计算理论缺血半暗带(IP).比较梗死核心(IC)、IP区CBF和ADC与对侧的差异,分析病灶-对侧相对值(rCBF、rADC)在两组间的差异.结果 IC区高灌注3例(A组0例,B组3例),IC区等灌注9例(A组1例,B组8例),IC区低灌注44例(A组19例,B组25例).SCBF> SDWI 41例(A组19例,B组22例),SCBF≈SDWI 15例(A组1例,B组14例).IC区的CBF和ADC值在两组中均较对侧降低(P<0.05).两组理论IP区的CBF值和A组理论IP区的ADC值均低于对侧(P<0.05).A组IC区的rADC高于B组,相反,A组理论IP区的rCBF、rADC低于B组(P<0.05).结论 临床可联合应用3D-pcASL和DWI序列对发病时间不具体的急性缺血性脑梗死进行鉴别诊断,从而有助于及时合理的选择个体化治疗方案.
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Key words
Arterial spin labeling,Apparent diffusion coefficient,Cerebral blood flow,Cerebral infarction,Magnetic resonance imaging
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