| 汪雪枫,肖新兰,唐小平,黄少武.三维准连续式动脉自旋标记评估单侧大脑中动脉狭窄致急性缺血性脑卒中影像学进展[J].中国医学影像技术,2019,35(1):41~45 |
| 三维准连续式动脉自旋标记评估单侧大脑中动脉狭窄致急性缺血性脑卒中影像学进展 |
| Three-dimensional pseudo-continuous arterial spin labeling assessment of imaging progress in acute ischemic stroke with unilateral middle cerebral artery stenosis |
| 投稿时间：2018-05-15 修订日期：2018-09-20 |
| DOI：10.13929/j.1003-3289.201805095 |
| 中文关键词: 脑卒中 大脑中动脉 脑血流 侧支循环 磁共振成像 自旋标记 |
| 英文关键词:stroke middle cerebral artery cerebral blood flow collateral circulation magnetic resonance imaging spin labeling |
| 基金项目:江西省科技厅社会发展领域重大项目（20152ACG70013）、江西省卫生计生委科技计划项目（20185246）。 |
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| 中文摘要: |
| 目的 探讨三维准连续式动脉自旋标记（3D-pcASL）评估单侧大脑中动脉（MCA）狭窄致急性缺血性脑卒中影像学进展的价值。方法 回顾性分析31例单侧MCA狭窄致急性缺血性脑卒中患者的MRI资料。根据入院时及入院7天内全脑DWI表现将患者分为进展组20例及无进展组11例。分别在标记后延迟（PLD）时间为1.5 s 及2.5 s条件下对2组行全脑3D-pcASL扫描，检测2组患侧（MCA狭窄侧）、健侧额叶、顶叶、颞叶、枕叶皮层和前外分水岭区、后外分水岭区、内分水岭区、基底核区侧支循环代偿脑血流量（ΔCBF）值，比较上述ΔCBF值差异。绘制ROC曲线，评价患侧各脑区侧支循环ΔCBF值对单侧MCA狭窄致急性缺血性脑卒中影像学进展的诊断效能。结果 进展组患侧、健侧后外分水岭区侧支循环ΔCBF值均较无进展组相应脑区降低（P均<0.05）。患侧后外分水岭区侧支循环ΔCBF值诊断脑卒中影像学进展的AUC为0.750，敏感度为0.85，特异度为0.64；内分水岭区的AUC为0.709，敏感度为0.95，特异度为0.55。结论 3D-pcASL可评价单侧MAC狭窄致急性缺血性脑卒中患者的侧支循环代偿情况，有助于早期诊断脑卒中影像学进展。 |
| 英文摘要: |
| Objective To assess the value of three-dimensional pseudo-continuous arterial spin labeling(3D-pcASL)in assessment of imaging progress in acute ischemic stroke with unilateral middle cerebral artery (MCA) stenosis. Methods MRI data of 31 patients of acute ischemic stroke with unilateral MCA stenosis were analyzed retrospectively. According to the whole brain DWI characteristics at the time of admission and within 7 days after admission, the patients were divided into progressive group (n=20) and non-progressive group (n=11). 3D-pcASL with post-labeling delay (PLD) of 1.5 s and 2.5 s were performed. The value of blood flow of collateral circulation (ΔCBF) in bilateral (involved side and healthy side) brain regions,including frontal, parietal, temporal and occipital cortices, anterior watershed, internal watershed, posterior watershed and basal ganglia were measured and compared between 2 groups. ROC curve was used to evaluate the efficacy of each region's ΔCBF at involved side in diagnosis of imaging progress of acute ischemic stroke with unilateral MCA stenosis. Results Progress group had significantly lower ΔCBF value in the posterior watershed of both sides compared with non-progressive group (both P<0.05). The area under ROC curve (AUC) of ΔCBF value in posterior watershed at involved side was 0.750, the sensitivity and specificity was 0.85 and 0.64, while in internal watershed were 0.709, 0.95 and 0.55, respectively. Conclusion 3D-pcASL can estimate the compensatory status of collateral circulation in acute ischemic stroke patients with unilateral MCA stenosis, being helpful to early diagnosis of imaging progress of acute ischemic stroke. |
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