摘要
目的探讨磁共振血管成像(magnetic resonance angiography,MRA)、三维动脉自旋标记技术(three-dimensional arterial spin labeling,3D-ASL)及体素内不相干运动成像(intravoxel incoherent motion,IVIM)在短暂性脑缺血发作(transient ischemic attack,TIA)中的应用价值。材料与方法选取52例临床诊断TIA患者,并在首次发作24 h内行磁共振检查,扫描序列包括头颅磁共振平扫,弥散加权成像(diffusion weighted imaging,DWI)、MRA、3D-ASL(PLD=1.5s)及IVIM。评估不同方法对TIA患者低灌注的检出率,进行χ^2检验,将患侧低灌注区域脑血流量(cerebral blood flow,CBF)、纯扩散系数(purediffusioncoefficient,D)、假扩散系数(pseudo-diffusioncoefficient,D^*)及灌注分数(perfusion fraction,f)与对侧正常脑组织进行配对t检验,rD^*值及rf值分别与rCBF进行Pearson相关性分析。结果ASL与f值比较,二者对低灌注检出率差异无统计学意义(P>0.05)。MRA、3D-ASL及f值三者联合检出率与MRA联合ASL相比无显著差异(P=0.426)。D值未发现阳性结果。患侧CBF、f值明显低于对侧正常脑组织,差异有统计学意义(P<0.05)。与对侧正常脑组织相比,患侧D值、D^*值无明显变化,差异无统计学意义(P>0.05)。rf值与rCBF之间有显著相关性(r=0.464,P=0.001),rD^*值与rCBF之间无显著相关性。结论IVIM f值与ASL有较好的一致性,两者均可以无创评估脑组织灌注的真实情况,血管成像及灌注成像联合应用更是有利于早期诊断TIA,为临床提供精准的影像依据,早期救治,减少脑梗死发生。
Objective:To evaluate the value of magnetic resonance angiography(MRA),threedimensional arterial spin labeling(3D-ASL)and intravoxel incoherent motion imaging(IVIM)in transient ischemic attack(TIA).Materials and Methods:Fifty-two patients with clinically diagnosed TIA underwent multi-modal MRI scans including DWI,MRA,3D-ASL(PLD=1.5 s)and IVIM within 24 h of symptom onset.The detection rate of hypoperfusion in patients with TIA was evaluated by different methods,andχ^2 tests were performed.The paired t test was applied to compared cerebral blood flow(CBF),pure diffusion coefficient(D),pseudodiffusion coefficient(D^*)and perfusion fraction(f)measurements between hypoperfusion areas and contralateral normal brain regions.Pearson correlation was used to evaluate the correlations between rD^*,rf and rCBF.Results:There was no significant difference in the detection rate of hypoperfusion between ASL and f(P>0.05).There was no significant difference in the positive rate between the three techniques(MRA、ASL and IVIM)and MRA combined with ASL(P=0.426).No positive result was found in D.The CBF and f in the affected sides were lower than that of contralateral areas(P<0.05),and the difference was significant(P<005).The D and D^*between the affected sides and contralateral areas were not statistically significant(P>0.05).A significant correlation was detected between rf and rCBF.No statistically significant correlation was observed between rD^*and rCBF.Conclusions:The results of IVIM f and 3D-ASL for the diagnosis of changes of brain perfusion of patients with TIA are consistent,which can be used for evaluating the real situation of cerebral perfusion.The combination of angiography and perfusion imaging is more helpful for early diagnosis of TIA,providing accurate imaging basis for clinic,and early treatment for reducing the occurrence of cerebral infarction.
作者
李璇
吴江
杨朝慧
朱丽娜
牛衡
郝晓勇
LI Xuan;WU Jiang;YANG Zhaohui;ZHU Lina;NIU Heng;HAO Xiaoyong(Department of Magnetic Resonance,Cardiovascular Hospital of Shanxi Province,Taiyuan 030024,China)
出处
《磁共振成像》
CAS
2020年第5期321-325,共5页
Chinese Journal of Magnetic Resonance Imaging
基金
山西省重点研发计划项目(编号:201703D321017-4)。
