磁共振灌注成像在烟雾病患者脑血流动力学评估中的应用

doi:10.13481/j.1671-587x.20160537

吉林大学学报(医学版) ›› 2016, Vol. 42 ›› Issue (05): 1024-1029.doi: 10.13481/j.1671-587x.20160537

磁共振灌注成像在烟雾病患者脑血流动力学评估中的应用

巨昕薇¹, 张帅², 冯加纯³, 佟丹¹

1. 吉林大学第一医院放射科, 吉林长春 130021;
2. 吉林省肿瘤医院放射科, 吉林长春 130012;
3. 吉林大学第一医院神经内科, 吉林长春 130021

收稿日期:2015-08-14 出版日期:2016-09-28 发布日期:2016-09-29
通讯作者: 佟丹,教授,硕士研究生导师(Tel:0431-88782519,E-mail:tongdan2012@126.com) E-mail:tongdan2012@126.com
作者简介:巨昕薇(1987-),女,吉林省长春市人,医师,医学硕士,主要从事神经系统影像诊断方面的研究。
基金资助:
国家自然科学基金资助课题（81271293）

Application of MR perfusion imaging in evaluation of hemodynamic of patients with moyamoya disease

JU Xinwei¹, ZHANG Shuai², FENG Jiachun³, TONG Dan¹

1. Department of Radiology, First Hospital, Jilin University, Changchun 130021, China;
2. Department of Radiology, Jilin Cancer Hospital, Changchun 130012, China;
3. Department of Neurology, First Hospital, Jilin University, Changchun 130021, China

Received:2015-08-14 Online:2016-09-28 Published:2016-09-29

摘要/Abstract

摘要：

目的：应用磁共振灌注成像技术评价烟雾病患者的脑血流动力学情况，探讨代偿性侧支循环形成与灌注的关系。方法：选取经临床确诊为烟雾病的住院患者72例作为典型烟雾病组，其中男性37例，女性35例，年龄10~62岁，所有患者均行脑血管造影（DSA）和磁共振灌注成像检查。并选取20例无神经系统病史的患者作为正常对照组。以平均通过时间（MTT）图像为标准，将异常灌注范围划为感兴趣区（ROI），分别记录相应的灌注参数值，包括脑血流量（CBF）、脑血容量（CBV）、MTT和达峰时间（TTP）。本研究以小脑作为参照，对灌注参数值进行标准化处理，得到灌注参数相对比值（rMTT、rTTP、rCBF和rCBV）。结果：与正常对照组比较，典型烟雾病组患者rMTT和rTTP延长、rCBF减低（P<0.05或P<0.01），而rCBV差异无统计学意义（P>0.05）；与健侧比较，烟雾病患者患侧rMTT和rTTP延长、rCBF和rCBV减低（P<0.05或P<0.01）；与慢性起病组比较，急性起病组患者rCBV和rCBF减低（P<0.05或P<0.01），rMTT和rTTP比较差异无统计学意义（P>0.05）；出血型与缺血型患者之间各灌注参数比较差异无统计学意义（P>0.05）。结论：磁共振脑灌注成像能够准确评价烟雾病患者脑血流动力学情况，MTT和TTP较CBF、CBV的敏感性更高。采用磁共振灌注成像可评价烟雾病患者侧支循环代偿情况，为临床医生选择适当的手术时机和最佳术式提供客观依据。

关键词: 烟雾病, 磁共振灌注成像, 脑血流动力学, 侧支循环

Abstract:

Objective: To evaluate the hemodynamic situation of the patients with moyamoya disease using MR perfusion imaging, and to explore the relationship between compensatory collateral circulation and perfusion. Methods: Seventy-two hospitalized patients with moyamoya disease were selected as typical moyamoya disease group, including 37 males and 35 females, aged 10-62 years old, all patients underwent cerebral angiography (DSA) and MR perfusion imaging. And 20 patients with out neurological history were used as control group. With mean transit time (MTT) image as a standard, the abnormal perfusion ranges were classified as region of interest (ROI),and the corresponding perfusion parameter values, including cerebral blood flow (CBF), cerebral blood volume (CBV), MTT and time to peak (TTP) were recorded,respectively. The cerebellum was used as a reference in this study, the perfusion parameters were standardized, and the relative ratios of the perfusion parameters(rMTT,rTTP,rCBF,rCBV) were obtained. Results:Compared with control group,the rMTT and rTTP of the patients in typical moyamoya disease group were prolonged and the rCBF was reduced (P<0.05 or P<0.01), but the rCBV had no obvious difference(P>0.05). ② Compared with the contralateral side, the rMTT and rTTP of the suffered side were prolonged,and the rCBF and rCBV were reduced (P<0.05 or P<0.01).Compared with chronic onset group,the rCBV and rCBF of the patients in acute onset group were reduced(P<0.05 or P<0.01),but the rMTT and rTTP had no statistically significant difference (P>0.05). There were no significant differences in all parameters between hemorrhagic moyamoya disease group and ischemia group(P>0.05). Conclusion: MR perfusion imaging can accurately evaluate the hemodynamic condition of moyamoya disease; MTT and TTP hve higher sensitivities than CBF and CBV. MR perfusion imaging can evaluate the compensation of collateral circulation of moyamoya disease and provide the objective basis for the clinician to select the proper surgical timing and the best operation methods.

Key words: moyamoya disease, magnetic resonance perfusion imaging, cerebral hemodynamics, collateral circulation

中图分类号:

R445.2

巨昕薇, 张帅, 冯加纯, 佟丹. 磁共振灌注成像在烟雾病患者脑血流动力学评估中的应用[J]. 吉林大学学报(医学版), 2016, 42(05): 1024-1029.

JU Xinwei, ZHANG Shuai, FENG Jiachun, TONG Dan. Application of MR perfusion imaging in evaluation of hemodynamic of patients with moyamoya disease[J]. Journal of Jilin University Medicine Edition, 2016, 42(05): 1024-1029.

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磁共振灌注成像在烟雾病患者脑血流动力学评估中的应用

Application of MR perfusion imaging in evaluation of hemodynamic of patients with moyamoya disease

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