摘要
目的通过评价大脑中动脉狭窄性脑梗死患者磁共振液体衰减反转恢复(fluid-attenuated inversion recovery,FLAIR)血管高信号征(FLAIR vascular hyperintensity,FVH)与磁共振灌注加权成像(magnetic resonance perfusion weighted imaging,MR-PWI)相关参数的相关性,探讨FVH相关的血流动力学因素及FVH对患者短期临床预后的影响。方法收集2020年1月至2022年12月复旦大学附属中山医院青浦分院神经内科大脑中动脉狭窄性脑梗死患者共116例,根据FVH诊断标准分为FVH(+)组78例,FVH(-)组38例,所有病例均完善头颅磁共振(magnetic resonance,MR)检查及MR-PWI检查。收集人口统计学、脑血管病危险因素,采用美国国立卫生研究院卒中量表评估患者入院时及出院时临床神经功能,采用简易智力状态检查(mini-mental state examination,MMSE)对患者的认知功能进行评定,出院90 d时采用改良Rankin量表(modified Rankin scale,mRS)评分对患者进行短期临床转归的评估。评价与患者临床症状相关的大脑中动脉狭窄程度、FVH阳性与否、FVH评分、低灌注体积及PWI相关参数,包括达峰时间(peak time,Tmax)、平均通过时间(mean transit time,MTT)、脑血容量(cerebral blood volume,CBV)及脑血流量(cerebral blood flow,CBF)。采用SPSS 22.0统计软件进行t检验、χ^(2)检验及Pearson相关分析。结果FVH(+)组和FVH(-)组低灌注体积、Tmax、MTT、CBF值差异有统计学意义(t=1.989,3.830,5.223,3.911,均P<0.05);短期临床转归方面,FVH(+)组神经功能好转率明显低于FVH(-)组[(8.25±6.39)%,(12.22±6.08)%],MMSE评分低于FVH(-)组[(25.48±1.59)分,(26.31±1.26)分],同时住院期间发生进展性卒中者多于FVH(-)组[22(28.21%),4(10.53%)],均差异有统计学意义(均P<0.05)。通过Pearson相关分析,FVH评分与低灌注体积(r=0.786,P<0.01)、MTT(r=0.692,P<0.01)呈正相关,与CBF呈负相关(r=-0.568,P<0.01),而与动脉的狭窄程度无相关性(r=0.363,P>0.05)。结论FVH与PWI所显示的Tmax、MTT�
Objective To evaluate the correlation between vascular hyperintensity of magnetic resonance fluid-attenuated inversion recovery(FLAIR)sequence(FVH)and related parameters of magnetic resonance perfusion weighted imaging(MR-PWI)in patients with middle cerebral artery stenosis cerebral infarction,and to explore the hemodynamic factors related to FVH and the effect of FVH on the short-term clinical prognosis of patients.Methods A total of 116 patients with middle cerebral artery stenosis cerebral infarction in the Department of Neurology,Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University from January 2020 to December 2022 were collected.According to the diagnostic criteria of FVH,they were divided into FVH(+)group(78 cases)and FVH(-)group(38 cases).All patients underwent magnetic resonance(MR)and MR-PWI scans.Demographic and cerebrovascular risk factors were collected,clinical neurological function of patients was assessed by national institate of health stroke scale(NIHSS)upon admission and discharge,and cognitive function of patients was assessed by mini-mental state examination(MMSE).Short-term clinical outcome was assessed using modified Rankin scale(mRS)at the 90th day after discharge.The degree of middle cerebral artery stenosis,positive or negative FVH,FVH score,hypoperfusion volume and MR-PWI related parameters,including peak time(Tmax),mean transit time(MTT),cerebral blood volume(CBV)and cerebral blood flow(CBF),were evaluated in relation to clinical symptoms.SPSS 22.0 statistical software was used for t test,Chi-square test and Pearson correlation analysis.Results There were significant differences in hypoperfusion volume,Tmax,MTT and CBF between FVH(+)group and FVH(-)group(t=1.989,3.830,5.223,3.911,all P<0.05).In terms of short-term clinical outcome,the improvement rate of neurological function((8.25±6.39)%,(12.22±6.08)%)and MMSE score(25.48±1.59),(26.31±1.26)in FVH(+)group were significantly lower than those in FVH(-)group,and the number of patients with progressive stroke during hospi
作者
刘振宝
杨位霞
李秋
田青
顾嘉晨
吴卫文
Liu Zhenbao;Yang Weixia;Li Qiu;Tian Qing;Gu Jiachen;Wu Weiwen(Department of Neurology,Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University,Shanghai 201700,China)
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2024年第2期128-132,共5页
Chinese Journal of Behavioral Medicine and Brain Science
基金
上海市青浦区卫生健康委员会科研课题(w2021-11)。
关键词
脑梗死
液体衰减反转恢复序列
血管高信号征
磁共振灌注加权成像
脑血流量
脑血容量
Cerebral infarction
Fluid-attenuated inversion recovery
Vascular hyperintensities
Magnetic resonance perfusion weighted imaging
Cerebral blood flow
Cerebral blood volume
