摘要
目的应用MR脑弥散成像(DWI)和灌注成像(PWI)技术,分析单侧大脑中动脉(middle cerebral artery,MCA)狭窄、闭塞患者脑组织血液动力学的变化,并判断缺血半暗带(ischemic penumbra IP)的存在。方法将73例单侧MCA狭窄、闭塞患者分成狭窄组和闭塞组,所有患者均行常规MRI、MRA、DWI及动态磁敏感对比增强(dynamic susceptibilitycontrast-enhanced,DSC)灌注成像扫描。比较ADC值及脑灌注结果,分析两组间二者的差异,并比较患侧DWI、PWI病灶面积差异。结果 39例MCA狭窄的患者中20例(51.28%)DWI为高信号,31例(79.72%)灌注异常;34例MCA闭塞的患者中21例(61.76%)DWI为高信号,33例(97.06%)灌注异常。两组患者,患侧ADC值与镜像对侧脑组织比较均有显著差异(P<0.05);MCA狭窄组患侧rMTTr、TTP值与闭塞组比较,有显著差异(P<0.05)。60例(82.19%)患侧PWI病灶面积大于DWI病灶面积。结论 DWI能发现新鲜梗塞灶,但两组患者患侧ADC值比较,无显著差异;PWI能够显示MCA狭窄或闭塞区脑组织血流动力学变化,但两组患者病灶区PWI异常改变无显著差异;只有两者联合应用才可以判定是否存在缺血半暗带,从而为临床准确诊断、及时治疗提供帮助。
Objective By useing the technology of PWI and DWI to analyze the hemodynamic changes of brain in patients with unilateral MCA stenosis or occlusion,and show the ischemic penumbra.Methods 73 patients with unilateral MCA stenosis or occlusion were divided into stenosis group and occlusion group.Routine MRI,MRA,DWI and DSC-PWI were performed by all patients.The differences of the value of rADC and PWI between stenosis group and occlusion group were analyzed,the Lesions area of DWI and PWI were compared and the ischemic penumbra was shown.Results The imaging of 20 patients in 39 patients with MCA stenosis demonstrated high signal intensity on DWI,31 patients were abnormal on PWI;The imaging of 21 patients in 34 patients with MCA occlusion demonstrated high signal intensity on DWI,33 patients were abnormal on PWI;In the stenosis group and the occlusion group,the values of ADC of abnormal regions were statistically different with those of the contralatera sides（P0.05）.The values of rMTT、rTTP in patients with MCA occlusion were statistically different with those in patients with MCA stenosis（P0.05）.The Lesions area of 60 patients（82.19%）on PWI was lager than those on DWI.Conclusion DWI can find acute infarction,but there was no statistical difference in the value of ADC between the stenosis group and occlusion group;PWI can show the abnormal hemodynamic changes of brain in patients with unilateral MCA stenosis or occlusion,however,there was no statistical difference in the change of PWI between the two groups.So PWI combined with DWI can determine if there was the ischemic penumbra,and they play an important role in clinical diagnosis and treatment.
出处
《中国实验诊断学》
北大核心
2011年第10期1651-1654,共4页
Chinese Journal of Laboratory Diagnosis
基金
长春市科委社发处课题(No.2006126)
关键词
大脑中动脉
狭窄
闭塞
弥散加权成像
灌注加权成像
Middle cerebral artery
Stenosis
Occlusion
Diffusion-weighted imaging
Perfusion-weighted imaging
