目的探讨外周血中氧化三甲胺(TMAO)、血清淀粉样蛋白A(SAA)水平对慢性脑缺血(CCH)的诊断价值。方法纳入2022年2月至6月在四川省人民医院神经内科就诊的患者,根据核磁共振动脉自旋标记(ASL)检查结果分为CCH组(55例)和对照组(42例)。采用E...目的探讨外周血中氧化三甲胺(TMAO)、血清淀粉样蛋白A(SAA)水平对慢性脑缺血(CCH)的诊断价值。方法纳入2022年2月至6月在四川省人民医院神经内科就诊的患者,根据核磁共振动脉自旋标记(ASL)检查结果分为CCH组(55例)和对照组(42例)。采用ELISA法检测两组外周血中TMAO和SAA的表达量,采用ROC曲线分析其对CCH的诊断价值。结果CCH组TMAO和SAA表达量高于对照组(47.24±8.84 vs 40.81±8.33,t=3.639,P<0.05;14.04±2.70 vs 12.20±2.30,t=3.542,P<0.05)。TMAO、SAA高表达,有原发性高血压病是CCH发生的独立危险因素(P<0.05)。TMAO和SAA单独诊断CCH的ROC曲线下面积(AUC)分别为0.701(95%CI:0.594~0.809)和0.675(95%CI:0.565~0.786),两者联合检测诊断的AUC最高,为0.765(95%CI:0.667~0.863)。结论外周血TMAO和SAA与CCH的发生有关,可作为CCH的辅助诊断指标。展开更多
目的:探讨磁共振三维准连续动脉自旋标记(3D-pCASL)成像技术在急性缺血性脑卒中患者中临床诊断中的应用价值。方法:选择61例急性缺血性脑卒中患者,设为观察组;选择同期治疗的59例非急性缺血性脑卒中患者,设为对照组。两组均在完成常规...目的:探讨磁共振三维准连续动脉自旋标记(3D-pCASL)成像技术在急性缺血性脑卒中患者中临床诊断中的应用价值。方法:选择61例急性缺血性脑卒中患者,设为观察组;选择同期治疗的59例非急性缺血性脑卒中患者,设为对照组。两组均在完成常规磁共振弥散加权成像(DWI)及3D-pCASL检查;测量病灶及对侧镜像区域脑组织脑血流量(CBF);绘制ROC曲线,分析不同检查方法诊断效能。结果: 61例急性缺血性脑卒中患者最终均得到确诊,患者经3D-pCASL成像技术检测确诊60例,诊断符合率为98.36%( P >0.05);DWI检查确诊58例,诊断符合率95.08%( P >0.05);观察组患者健侧CBF水平与对照组比较,差异无统计学意义( P >0.05);观察组患者患侧CBF水平低于对照组( P <0.05);ROC曲线结果显示:单一DWI、3D-pCASL检查在急性缺血性脑卒中患者中的诊断特异性、敏感性均无统计学意义( P >0.05);DWI及3D-pCASL联合检查在急性缺血性脑卒中患者中的诊断特异性、敏感性,高于单一DWI、3D-pCASL检查( P <0.05)。结论:将3D-pCASL成像技术用于急性缺血性脑卒中患者中效果理想,能实现脑血流量的可视化,弥补传统DWI存在的弊端,为临床诊疗提供可靠的依据和参考。展开更多
Cerebral blood flow is strongly associated with brain function, and is the main symptom and diagnostic basis for a variety of encephalopathies. However, changes in cerebral blood flow after mild traumatic brain injury...Cerebral blood flow is strongly associated with brain function, and is the main symptom and diagnostic basis for a variety of encephalopathies. However, changes in cerebral blood flow after mild traumatic brain injury remain poorly understood. This study sought to observe changes in cerebral blood flow in different regions after mild traumatic brain injury using pulsed arterial spin labeling. Our results demonstrate maximal cerebral blood flow in gray matter and minimal in the white matter of patients with mild traumatic brain injury. At the acute and subacute stages, cerebral blood flow was reduced in the occipital lobe, parietal lobe, central region, subcutaneous region, and frontal lobe. Cerebral blood flow was restored at the chronic stage. At the acute, subacute, and chronic stages, changes in cerebral blood flow were not apparent in the insula. Cerebral blood flow in the temporal lobe and limbic lobe diminished at the acute and subacute stages, but was restored at the chronic stage. These findings suggest that pulsed arterial spin labeling can precisely measure cerebral blood flow in various brain regions, and may play a reference role in evaluating a patient＇s condition and judging prognosis after traumatic brain injury.展开更多
文摘目的探讨外周血中氧化三甲胺(TMAO)、血清淀粉样蛋白A(SAA)水平对慢性脑缺血(CCH)的诊断价值。方法纳入2022年2月至6月在四川省人民医院神经内科就诊的患者,根据核磁共振动脉自旋标记(ASL)检查结果分为CCH组(55例)和对照组(42例)。采用ELISA法检测两组外周血中TMAO和SAA的表达量,采用ROC曲线分析其对CCH的诊断价值。结果CCH组TMAO和SAA表达量高于对照组(47.24±8.84 vs 40.81±8.33,t=3.639,P<0.05;14.04±2.70 vs 12.20±2.30,t=3.542,P<0.05)。TMAO、SAA高表达,有原发性高血压病是CCH发生的独立危险因素(P<0.05)。TMAO和SAA单独诊断CCH的ROC曲线下面积(AUC)分别为0.701(95%CI:0.594~0.809)和0.675(95%CI:0.565~0.786),两者联合检测诊断的AUC最高,为0.765(95%CI:0.667~0.863)。结论外周血TMAO和SAA与CCH的发生有关,可作为CCH的辅助诊断指标。
文摘目的:探讨磁共振三维准连续动脉自旋标记(3D-pCASL)成像技术在急性缺血性脑卒中患者中临床诊断中的应用价值。方法:选择61例急性缺血性脑卒中患者,设为观察组;选择同期治疗的59例非急性缺血性脑卒中患者,设为对照组。两组均在完成常规磁共振弥散加权成像(DWI)及3D-pCASL检查;测量病灶及对侧镜像区域脑组织脑血流量(CBF);绘制ROC曲线,分析不同检查方法诊断效能。结果: 61例急性缺血性脑卒中患者最终均得到确诊,患者经3D-pCASL成像技术检测确诊60例,诊断符合率为98.36%( P >0.05);DWI检查确诊58例,诊断符合率95.08%( P >0.05);观察组患者健侧CBF水平与对照组比较,差异无统计学意义( P >0.05);观察组患者患侧CBF水平低于对照组( P <0.05);ROC曲线结果显示:单一DWI、3D-pCASL检查在急性缺血性脑卒中患者中的诊断特异性、敏感性均无统计学意义( P >0.05);DWI及3D-pCASL联合检查在急性缺血性脑卒中患者中的诊断特异性、敏感性,高于单一DWI、3D-pCASL检查( P <0.05)。结论:将3D-pCASL成像技术用于急性缺血性脑卒中患者中效果理想,能实现脑血流量的可视化,弥补传统DWI存在的弊端,为临床诊疗提供可靠的依据和参考。
文摘Cerebral blood flow is strongly associated with brain function, and is the main symptom and diagnostic basis for a variety of encephalopathies. However, changes in cerebral blood flow after mild traumatic brain injury remain poorly understood. This study sought to observe changes in cerebral blood flow in different regions after mild traumatic brain injury using pulsed arterial spin labeling. Our results demonstrate maximal cerebral blood flow in gray matter and minimal in the white matter of patients with mild traumatic brain injury. At the acute and subacute stages, cerebral blood flow was reduced in the occipital lobe, parietal lobe, central region, subcutaneous region, and frontal lobe. Cerebral blood flow was restored at the chronic stage. At the acute, subacute, and chronic stages, changes in cerebral blood flow were not apparent in the insula. Cerebral blood flow in the temporal lobe and limbic lobe diminished at the acute and subacute stages, but was restored at the chronic stage. These findings suggest that pulsed arterial spin labeling can precisely measure cerebral blood flow in various brain regions, and may play a reference role in evaluating a patient＇s condition and judging prognosis after traumatic brain injury.
