摘要
目的探讨三维动脉自旋标记成像(3D-ASL)技术能否发现扩散加权成像(DWI)及MR血管成像(MRA)显示为阴性短暂性脑缺血发作(TIA)病人的脑血流灌注异常。方法回顾性分析112例经临床确诊而DWI及MRA阴性的TIA病人[男63例,女49例,平均年龄(58.41±4.92)岁]及67例健康志愿者[男35例,女32例,平均年龄(54.70±6.36)岁]的3D-ASL资料。将TIA资料依据症状分为单发作组(发作1次)与频发作组(>1次)。3名医师共同观察动脉自旋标记(ASL)脑血流量(CBF)图并测量兴趣区相对CBF(r CBF值),计算r CBF比值(灌注异常区的r CBF值/镜像区r CBF值)。采用卡方检验比较两组资料构成有无差异,采用独立样本t检验比较两组r CBF比值有无差异。并判断TIA病人临床症状与灌注异常区是否具有一致性。结果 112例TIA病人中发现灌注异常者69例(61.6%),灌注正常43例(38.4%);健康受试者中灌注减低7例(10.4%),灌注正常60例(89.6%),TIA病人的灌注异常者明显多于健康受试者(χ2=44.91,P<0.05),平均r CBF比值(0.78±0.19)低于健康受试者(0.96±0.15)(t=56.2,P<0.05)。TIA症状单发作组与频发作组的r CBF值差异无统计学意义(t=0.34,P>0.05)。69例灌注异常TIA中,颈内动脉系统TIA的临床症状与灌注异常区相匹配的50例;椎基底动脉系统TIA的临床症状与灌注异常区匹配为9例。结论 3D-ASL有助于发现DWI及MRA阴性的TIA的灌注异常,有利于明确TIA的早期病生理状态。
Objective To explore whether three dimensioned arterial spin-labeling（3D-ASL） can detect abnormality in transient ischemic attack （TIA） patients with negative DWI and MRA finding. Methods The 3D-ASL data of 112 cases （63 males and 49 females, 58.41 ±4.92 years old） who were clinically diagnosed as TIA with negative DWI and MRA examination, and 3D-ASL data of 67 healthy volunteers （35 males and 32 females, 54.70 ±6.36years old） were studied. According to the number of symptoms, the TIA data were divided into single symptom group （1 time） and frequent symptom group （more than 1 time）. Three doctors observed the ASL cerebral blood flow （CBF） map together and measured the value of relative cerebral blood flow（rCBF） of regions of interest. Then, rCBF ratios （rCBF value of the abnormal area of perfusion/rCBF value of the mirror area）were calculated.Chi square test was used to compare the difference in presence of abnormality, and independent sample t test was used to compare the difference in rCBF ratios among groups.In addition,the relationship between clinical symptoms and locations of perfusion abnormalities in patients with TIA was assessed. Results Among the 112 cases of TIA, abnormal perfusion was found in 69 cases （61.6%）, normal perfusion in 43 cases （38.4%）. In the 67 healthy volunteers, low perfusion was found in 7 cases （10.4%）, normal perfusion in 60 cases （89.6%）. The frequency of presenting abnormal perfusion was significantly higher （χ^2=44.91, P〈0.05）, and mean rCBF ratio was significantly lower in the TIA patients than in the healthy volunteers（0.78±0.19 vs. 0.96±0.15, t=56.2, P〈0.05）. There was no significant difference in rCBF between the single symptom group and the frequent symptom group （t=0.34, P〉0.05）. Among the 69 TIA cases with abnormal perfu-sion,the clinical symptoms matched the locations of abnormal perfusion in internal carotid artery territory in 50 cases, and in vertebral basilar artery territory in 9 cases. Conclusion 3D-ASL can help to detect abnormal perfusion in the TIA patients with negative DWI and MRA finding,and is helpful for clarifying the early physiological state of TIA.
出处
《国际医学放射学杂志》
2017年第3期245-248,共4页
International Journal of Medical Radiology
关键词
短暂性脑缺血发作
动脉自旋标记
脑血流量
灌注加权成像
扩散加权成像
磁共振血管成像
Transient ischemic attack
Arterial spin-labeling
Cerebral blood flow
Perfusion weighted imaging
Dif-fusiong weighted imaging
Magnetic resonance agiography
