摘要
目的分析3.0T磁共振脑灌注加权成像(MRI-PWI)在急性脑梗死(ACI)患者侧支循环评估中的应用价值。方法回顾性分析2021年1月至2024年10月郑州市第一人民医院收治的83例ACI患者的临床资料。患者入院后均进行数字减影血管造影(DSA)及MRI-PWI检查,并根据侧支循环分级结果分为较差组(1~2级侧支循环代偿较差)和良好组(3~4级侧支循环代偿良好)。MRI-PWI检查后进行影像学分析,并计算梗死侧相对脑血容量(rCBV)、相对脑血流量(rCBF)、相对平均通过时间(rMTT)、相对最大峰值时间(rTTP);比较两组MRI-PWI检查相关参数,进一步分析上述参数单一及联合鉴别诊断ACI患者侧支循环的价值。结果83例ACI患者侧支循环建立1级13例,2级24例,3级30例,4级16例;侧支循环代偿较差37例,侧支循环代偿良好46例。良好组rCBV、rCBF高于较差组,rMTT、rTTP低于较差组(P<0.05)。进一步绘制受试者工作特征曲线结果显示,rCBV、rCBF、rMTT、rTTP单一及联合鉴别诊断ACI患者侧支循环建立的曲线下面积均>0.7,有一定预测价值,且联合检测可提高预测价值。结论3.0T MRI-PWI可有效评估ACI患者侧支循环代偿情况,能够为ACI患者病情及梗死情况评估提供客观价值。
Objective To analyze the application value of 3.0T magnetic resonance cerebral perfusion weighted imaging(MRI-PWI)in the assessment of collateral circulation in patients with acute cerebral infarction(ACI).Methods The clinical data of 83 ACI patients admitted to Zhengzhou First People’s Hospital from January 2021 to October 2024 were retrospectively analyzed.After admission,all the selected patients underwent digital subtraction angiography(DSA)and MRI-PWI examinations,and they were divided into the poor group(grade 1-2,with poor collateral circulation compensation)and the good group(grade3-4,with good collateral circulation compensation)based on collateral circulation grading results.After MRI-PWI examination,imaging analysis was performed to calculate the relative cerebral blood volume(rCBV),relative cerebral blood flow(rCBF),relative mean transit time(rMTT),and relative time to peak(rTTP)on the infarcted side.MRI-PWI examination related parameters of the two groups were compared to further analyze the value of single and combined parameters in the differential diagnosis of collateral circulation in ACI patients.Results Among the 83 patients with ACI,13 patients were with grade 1 collateral circulation,and 24 patients with grade 2 collateral circulation,30 patients with grade 3 collateral circulation,16 patients with grade 4 collateral circulation.Among them,37 patients were with poor collateral circulation compensation,and 46 patients with good collateral circulation compensation.The rCBV and rCBF of the good group were higher than those of the poor group,while rMTT and rTTP were lower than those of the poor group(P<0.05).The results of the receiver operating characteristic curve showed that the area under the curve established by rCBV,rCBF,rMTT,rTTP and combination of them in differential diagnosis of collateral circulation in ACI patients were all greater than 0.7,indicating certain predictive value,and combined detection can improve predictive value.Conclusions 3.0T MRI-PWI can effectively evaluate collateral circulation compensation in patients with ACI,providing objective value for assessing the condition and infarction status of ACI patients.
作者
段大兵
郭晓强
尹世更
Duan Dabing;Guo Xiaoqiang;Yin Shigeng(Department of Medical Imaging,Zhengzhou First People’s Hospital,Zhengzhou 450000,China;Department of Medical Imaging,Zhengzhou People’s Hospital,Zhengzhou 450000,China)
出处
《中国实用医刊》
2025年第8期75-78,共4页
Chinese Journal of Practical Medicine
关键词
脑梗死
磁共振成像
灌注加权成像
侧支循环
脑血流灌注
Cerebral infarction
Magnetic resonance imaging
Perfusion weighted imaging
Collateral circulation
Cerebral blood flow perfusion
