应用MR弥散和灌注技术分析大脑中动脉狭窄供血区血流状况的比较

J4 ›› 2011, Vol. 37 ›› Issue (2): 351-356.

应用MR弥散和灌注技术分析大脑中动脉狭窄供血区血流状况的比较

王静|周宏伟|孔博玉|程艳华|谷艳英

吉林大学第一医院放射科| 吉林长春 130021

收稿日期:2010-07-22 出版日期:2011-03-28 发布日期:2011-03-28
通讯作者: 谷艳英(Tel：0431-88782541，E-mail：ctwest@163.com) E-mail:ctwest@163.com
作者简介:王静(1976-)|女|吉林省长春市人|主治医师|在读医学博士|主要从事中枢神经系统疾病的影像诊断方面的研究。
基金资助:
吉林省科技厅科研基金资助课题（200705132）

Comparison between MR diffusion and perfusion in analysis of blood supply of |cerebral middle artery stenosis

WANG Jing|ZHOU Hong-wei, KONG Bo-yu, CHENG Yan-hua|GU Yan-ying

Department of Radiology,First Hospital,Jilin University,Changchun 130021,China

Received:2010-07-22 Online:2011-03-28 Published:2011-03-28

摘要/Abstract

摘要：

［摘要］目的：探讨磁共振的动态磁敏感对比增强（DSC-MRI）技术和动脉自旋标记（ASL）方法的差异，并明确ASL方法在缺血性脑血管病患者脑血流灌注中的应用价值。方法：回顾性分析48例经磁共振血管造影(MRA)证实的一侧大脑中动脉(MCA)狭窄或闭塞的短暂性脑缺血发作（TIA）患者的影像学资料，并选择35例健康志愿者作为对照，通过ASL和DSC两种灌注加权成像（PWI）技术扫描，得到平均脑血流量（CBF）图和灌注参数图，与弥散加权成像（DWI）所得参数图比较，观察两种方法判定MCA狭窄侧脑组织血流灌注的差异。结果：ASL方法显示，患侧脑组织局部脑血流量（rCBF）为（30.4±8.2） mL·100 g^-1·min^-1，对侧脑组织的rCBF为（58.3±11.4）mL·100 g^-1·min^-1，患侧脑组织rCBF低于正常侧脑组织（P<0.05）;DSC方法显示，患侧rCBF为（28.7±12.8）mL·100 g^-1·min^-1，对侧脑组织的rCBF为（54.2±9.5） mL·100 g^-1·min^-1，患侧rCBF低于正常侧脑组织（P<0.05）；ASL和DSC方法检测同一血管狭窄侧脑组织的rCBF，两组rCBF的差异无统计学意义(P>0.05)〖JP3〗。ASL和DSC方法显示，健康志愿者的rCBF分别为（56.8±10.7） mL·100 g^-1·min^-1和（55.2±9.8）mL·100 g^-1·min^-1，与血管狭窄对侧的正常脑组织的rCBF两两比较差异无统计学意义（P>0.05）；DWI显示狭窄动脉供血区域异常的病灶表观弥散系数（ADC）平均值为（522.3±57.2)×10^-6 mm²·s^-1，对侧正常脑组织的ADC平均值为（756.8±67.6)×10^-6 mm²·s^-1，狭窄动脉供血区域ADC平均值低于对侧正常脑组织ADC平均值（P<0.05）。结论：ASL方法可以判定MCA狭窄患者的低灌注状态，弥散结合灌注扫描可以判定侧脑组织狭窄患者的缺血半暗带。

关键词: 动态磁敏感对比增强；动脉自旋标记；脑缺血半暗带；短暂性脑缺血发作

Abstract:

Abstract:Objective To discuss the ischemic information with dynamic susceptibility contrast-enhanced MR imaging（DSC-MRI） and artery spin labeling（ASL）technique in the patients with unilateral middle artery stenosis,and confirm the diagnosis value of the ASL perfusion technique in ischemic cerebravascular diseases. Methods 48 patients of transient ischemic attack（TIA） with unilateral middle cerebral artery (MCA) stenosis or occlusion and 35 healthy volunteers were collected. The concentration-time curve was got through cerebral blood flow (CBF) map and DSCimages. The difference of the cerebral perfusion in side of the MCA stenosis was observed by comparing the concentration-time curve between the two methods. Results The rCBF of ipsilateral MCA stenosis tissues was （30.4±8.2）mL·100 g^-1·min^-1 and （58.3±11.4） mL·100 g^-1·min^-1 of contralateral tissues detected with ASL-PWI method ,there was significant difference(P<0.05).The rCBF in ipsilateral MCA stenosis tissues was （28.7±12.8） mL·100 g^-1·min^-1 and （54.2±9.5） mL·100 g^-1·min^-1 of contralateral tissues detected with DSC-PWI method(P<0.05).The rCBF of ipsilateral tissue of the same blood vessel detected with ASL andDSC had no significant difference(P>0.05). The rCBF of healthy controls detected with ASL and DSC were （56.8±0.7） mL·100 g^-1·min^-1 and （55.2±9.8） mL·100 g^-1·min^-1 ,there were no significant differences compared with controlateral tissue of MCA stennosis(P>0.05).The apparent diffusion coefficient (ADC) value of ipsilateral MCA stenosis was （522.3±57.2×10^-6）mm²·s^-1 and （756.8±67.6×10^-6）mm²·s^-1  in contralateral tissue detected with DWI method,there was significant differerce(P<0.05). Conclusion ASL can measure the CBF data and the extent of low perfusion in MCA stenosis and occlusion;ASL in combination with DWI can indicate the ischemic penumbra in MCA stenosis patients.

Key words: dynamic susceptibility contrast-enhancement；artery spin labeling；ischemic penumbra；transient ischemic attack

中图分类号:

R743

王静|周宏伟|孔博玉|程艳华|谷艳英. 应用MR弥散和灌注技术分析大脑中动脉狭窄供血区血流状况的比较[J]. J4, 2011, 37(2): 351-356.

WANG Jing|ZHOU Hong-wei, KONG Bo-yu, CHENG Yan-hua|GU Yan-ying. Comparison between MR diffusion and perfusion in analysis of blood supply of |cerebral middle artery stenosis[J]. J4, 2011, 37(2): 351-356.