摘要
目的探讨基于三维动脉自旋标记(3D-ASL)成像技术对急性脑梗死溶栓后再灌注效果的评价意义。方法前瞻性选取2018年1月至2020年9月在本院进行溶栓治疗的急性脑梗死患者43例,根据溶栓前3D-ASL和弥散加权成像(DWI)的不同匹配情况将患者分为3D-ASL>DWI组(22例)、3D-ASL=DWI组(14例)和3D-ASL<DWI组(7例)。比较三组患者溶栓前后的表观弥散系数(ADC)值、脑血流量(CBF)值和NIHSS评分的变化,比较三组患者的溶栓疗效,分析溶栓疗效与3D-ASL/DWI匹配的相关性。结果3D-ASL>DWI组和3D-ASL=DWI组患者溶栓治疗后7 d的ADC值和CBF值均增加,NIHSS评分降低,差异有统计学意义(P<0.05),而3D-ASL<DWI组患者治疗前后的ADC值、CBF值和NIHSS评分比较,差异均无统计学意义(P均>0.05)。三组患者的溶栓疗效比较,差异有统计学意义(P<0.05)。经Spearman相关性分析显示,溶栓疗效与3D-ASL/DWI匹配有明显相关性(r=0.789,P<0.001)。结论3D-ASL可用于评价急性脑梗死溶栓后再灌注的效果,为治疗方案的选择提供影像学依据。
Objective To explore the significance of three-dimensional arterial spin labeling imaging(3D-ASL)in evaluating the effect of reperfusion after thrombolysis in patients with acute cerebral infarction.Methods A total of 43 patients with acute cerebral infarction who received thrombolytic therapy in our hospital from January 2018 to September 2020 were divided into three groups,3D-ASL>DWI group(n=22),3D-ASL=DWI group(n=14)and 3D-ASL<DWI group(n=7),according to the different matching of 3D-ASL and diffusion weighted imaging(DWI)before thrombolysis.The changes of apparent diffusion coefficient(ADC),cerebral blood flow(CBF)and NIHSS score of the three groups before and after thrombolysis were compared,and the thrombolytic effects of the three groups were compared.Analyze the correlation between thrombolytic efficacy and 3D-ASL/DWI matching.Results In 3D-ASL>DWI group and 3D-ASL=DWI group,ADC value and CBF value increased,and NIHSS score decreased at 7 days after thrombolytic therapy,and the difference was statistically significant(P<0.05).While there was no significant difference in ADC value,CBF value and NIHSS score in 3D-ASL<DWI group before and after treatment(P>0.05).There was significant difference in thrombolytic effect among the three groups(P<0.05).Spearman correlation analysis showed that there was a significant correlation between thrombolytic efficacy and different matching 3D-ASL/DWI(r=0.789,P<0.001).Conclusion 3D-ASL can be used to evaluate the effect of reperfusion after thrombolysis in acute cerebral infarction and provide imaging basis for the choice of treatment.
出处
《浙江临床医学》
2022年第4期493-495,499,共4页
Zhejiang Clinical Medical Journal
基金
浙江省中医药科技计划项目(2021ZA140)
浙江省医药卫生科技计划项目(2020RC133)。
关键词
三维动脉自旋标记
急性缺血性脑卒中
溶栓
再灌注治疗
效果评价
Three-dimensional arterial spin labeling
Acute ischemic stroke
Thrombolysis
Reperfusion therapyg
Effect evaluation
