摘要
目的对比分析体素内不相干运动成像(IVIM-MRI)与三维动脉自旋标记成像(3D-ASL)在评价缺血性脑梗死后脑血流灌注改变中的临床应用价值。方法 46例缺血性脑梗死患者分别行常规MRI、弥散加权成像(DWI)、3D-ASL和IVIM-MR检查。以DWI显示的梗死灶和镜像对照区作为感兴趣区,3D-ASL分别测量双侧局部脑血流量(CBF)变化。IVIM测量参数有表观扩散系数(ADC)、灌注分数(f)、假扩散系数(D*)以及扩散系数(D),将患侧与健侧参数进行配对t检验。同时计算所有参数的相对值(r=脑梗死区/健侧镜像区),同时将IVIM各参数相对值改变(r ADC、rf、rD*、rD)分别与r CBF进行Spearman相关性分析。结果梗死区CBFASL较对侧减低,两者差异有统计学意义(P<0.05)。梗死区ADC、f值、D值与健侧比较的差异有统计学意义(P<0.05)。梗死区D*值较健侧减低,但差异无统计学意义(P>0.05)。除rD*外,梗死区r ADC、rD、rf与rCBF的相关性具有统计学意义(P<0.05)。结论 IVIM-MR和3D-ASL在检出缺血性脑梗死患者的脑血流灌注改变方面具有一致性,可用于评价缺血性脑梗死后血流灌注改变,有利于指导临床。
Objective To compare and analyze the clinical application value of intravoxel incoherent motion perfusion imaging MRI（IVIM-MRI） and three-dimension arterial spin labeling（3D-ASL） imaging for evaluating changes of brain perfusion of patients with ischemic stroke.Methods A total of 46 patients with ischemic stroke underwent routine MRI with DWI,3D-ASI,and IVIM.Stroke areas indicated by DWI and contralateral normal areas were selected as regions of interest and changes of bilateral local cerebral blood flow（CBF） were measured by 3D-ASL.Parameters measured by IVIM were apparent diffusion coefficient（ADC）,diffusion coefficient of pure diffusion（D）,pseudo-diffusion coefficient（D＊）,and perfusion fraction（f）.Paired t test was performed for stroke areas and contralateral areas.The relative values of all parameters were also calculated（r = stroke area/contralateral area）.Spearman correlation analysis was performed for changes of relative values（rADC,rf,rD＊,and rD） of parameters of IVIM and rCBF.Results The C BF_（ASL） of stroke areas was lower than that of contralateral areas and the difference was significant（P〈0.05）.The differences of ADC,f,and D between stroke areas and contralateral areas were significant（P〈0.05）.The D of stroke areas was lower than that of contralateral areas and the difference was not statistically significant（P〈0.05）.Except rD,the differences between rADC,rD,and rf of stroke areas and rC BF_（ASL） were statistically significant（P〈0.05）.Conclusion The results of IVIM-MRI and 3D-ASL for the diagnosis of changes of brain perfusion of patients with ischemic stroke are consistent,which can be used for evaluating changes of brain perfusion after the incidence of ischemic stroke and are helpful for clinical diagnosis and treatment.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2015年第12期1837-1841,共5页
Journal of Shanghai Jiao tong University:Medical Science
基金
上海交通大学医工交叉基金面上项目(YG2014MS50)
上海市卫计委面上项目(201540231)
上海交通大学医学院附属仁济医院南院科研启动基金(2014QDM12)~~
关键词
动脉自旋标记成像
脑血流量
磁共振
体素内不相干运动成像
arterial spin labeling
cerebral blood flow
magnetic resonance imaging
intravoxel incoherent motion imaging
