1.5T光纤磁共振ASL、DTI、DWI及MRS评价急性缺血性脑梗死缺血半暗带的应用价值
|
摘要
目的:对1.5T光纤磁共振三维动脉自旋标记(ASL)、磁共振弥散张量成像(DTI)、弥散加权成像(DWI)及氢质子波谱(MRS)评价急性缺血性脑梗死缺血半暗带(IP)的应用价值进行分析和比较。方法:以我院2016年4月—2018年1月期间收治的30例初诊为急性脑梗死的患者为研究对象,对所有患者行1.5T光纤磁共振常规扫描及DWI、ASL、DTI及MRS扫描,对比分析不同方法的检测结果。结果:在DWI图像上,患者中心梗死区与IP区、对侧镜像区的ADC值存在显著差异(P <0.05),IP区与对侧镜像区之间ADC值无显著性差异(P> 0.05);在ASL图像上中心梗死区与IP区、对侧镜像区两两之间CBF值均有显著性差异(P <0.05);DTI检测中心梗死区、IP区与镜面对侧区两两之间的FA值均具有显著差异(P <0.05);1H-MRS检测,脑梗死病灶NAA值由正常组织至核心区逐步下降,与此同时Lac逐步增高。结论:1.5T光纤磁共振ASL、DTI、DWI及MRS的联合应用是评价急性缺血性脑梗死缺血半暗带的有效途径,能够在判断患者缺血半暗带是否存在的基础上,准确界定患者缺血半暗带范围,临床应用价值显著。
Objective Fiber magnetic resonance(NMR) 3 d 1.5 T arterial spin labeling(ASL), magnetic resonance diffusion tensor imaging(DTI) and diffusion weighted imaging(DWI) can and hydrogen proton spectroscopy(MRS) evaluation of ischemia half dark with acute, ischemic cerebral infarction(IP) application value are analyzed and compared. Methods In our hospital in April 2016-2018 was admitted during the period of January 30 cases of acute cerebral infarction patients as the research object, the optical fiber line 1.5 T magnetic resonance(NMR) in patients with all conventional scanning and DWI, ASL, DTI and MRS can scan, analysis of test results of different method. Results In the DWI image, there were significant differences in ADC values between the patients' central infarction area and the IP area and the corresponding mirror area(P<0.05), and there was no significant difference in ADC value between the IP area and the adjacent mirror area(P >0.05); There were significant differences in CBF values between the central infarction area and the IP area and the corresponding mirror area in the ASL image(P<0.05); There were significant differences in the FA values between the infarcted area, the IP area and the mirror in the DTI detection center(P<0.05); 1 h-mrs detection, NAA value of cerebral infarction was gradually decreased from normal tissue to core area, while Lac gradually increased. Conclusion 1.5 T optical fiber resonance ASL, DTI, DWI and combined application of MRS can is evaluation of acute, ischemic cerebral infarction ischemia and half dark with an effective way, in the judgment of ischemia in patients with half dark zone exists on the basis of accurate definition of ischemia in patients with half dark zone, significant clinical value.
Objective Fiber magnetic resonance(NMR) 3 d 1.5 T arterial spin labeling(ASL), magnetic resonance diffusion tensor imaging(DTI) and diffusion weighted imaging(DWI) can and hydrogen proton spectroscopy(MRS) evaluation of ischemia half dark with acute, ischemic cerebral infarction(IP) application value are analyzed and compared. Methods In our hospital in April 2016-2018 was admitted during the period of January 30 cases of acute cerebral infarction patients as the research object, the optical fiber line 1.5 T magnetic resonance(NMR) in patients with all conventional scanning and DWI, ASL, DTI and MRS can scan, analysis of test results of different method. Results In the DWI image, there were significant differences in ADC values between the patients' central infarction area and the IP area and the corresponding mirror area(P<0.05), and there was no significant difference in ADC value between the IP area and the adjacent mirror area(P >0.05); There were significant differences in CBF values between the central infarction area and the IP area and the corresponding mirror area in the ASL image(P<0.05); There were significant differences in the FA values between the infarcted area, the IP area and the mirror in the DTI detection center(P<0.05); 1 h-mrs detection, NAA value of cerebral infarction was gradually decreased from normal tissue to core area, while Lac gradually increased. Conclusion 1.5 T optical fiber resonance ASL, DTI, DWI and combined application of MRS can is evaluation of acute, ischemic cerebral infarction ischemia and half dark with an effective way, in the judgment of ischemia in patients with half dark zone exists on the basis of accurate definition of ischemia in patients with half dark zone, significant clinical value.
引文
[1]高峰,刘亦华,王旭磊,等.瑞替普酶治疗不同时间窗急性缺血性脑卒中的疗效评价[J].中华危重病急救医学,2016,(11):1029-1031.
[2]张若楠.3D-ASL、DTI、DWI序列联合应用对缺血性脑梗死缺血半暗带的诊断价值[D].内蒙古医科大学,2016.
[3]王欣,尹俊雄,霍晓丽,等.磁共振波普联合表观弥散系数与灌注加权成像联合D W I评价急性脑梗死后缺血半暗带的比较研究[J].临床神经病学杂志,2015,28(6),401-403.
[4]李伟,龙晚生,罗学毛,等.弥散加权成像联合磁共振波谱分析在脑梗死中的应用研究[J].生物医学工程学进展,2011,32(3),155-161.
[5]黄强辉.探讨双源CT灌注成像对缺血性脑卒中半暗带的变化与临床预后的关系[D].南昌大学,2015.
[6]温家华.全脑CT灌注成像快速评价脑梗死核心及缺血半暗带研究[D].重庆医科大学,2015.
[7]Lou Xin,Yu Songlin,Scalzo Fabien,Starkman Sidney,Ali Latisha K,Kim Doojin,Rao Neal M,Hinman Jason D,Vespa Paul M,Jahan Reza,Tateshima Satoshi,Gonzalez Nestor R,Duckwiler Gary R,Saver Jeffrey L,Yoo Bryan,Salamon Noriko,Lyu Jinhao,Ma Lin,Wang Danny Jj,Liebeskind David S.Multi-delay ASL can identify leptomeningeal collateral perfusion in endovascular therapy of ischemic stroke.[J].Oncotarget,2017,8(2).
[8]Hanne M.M.Rooijackers,Evita C.Wiegers,Cees J.Tack,Marinette van der Graaf,Bastiaan E.de Galan.Brain glucose metabolism during hypoglycemia in type1 diabetes:insights from functional and metabolic neuroimaging studies[J].Cellular and Molecular Life Sciences,2016,73(4).
[9]余乐熺,秦彤,王亚瑟,等.ADC及rADC值对缺血性脑梗死缺血半暗带的诊断价值[J].放射学实践,2015,30(9):928-931.
[10]曲鑫鑫,孙洪赞,朱文珍,等.DWI联合动脉自旋标记及MRA评价脑梗死缺血半暗带[J].中国医学影像技术,2014,30(1):11-15.
[11]Hernandez DA,Bokkers RP,Mirasol RV,et al.Pseudocontinuous arterial spin labeling quantifies relative cerebral blood flow in acute stroke.Stroke,2012,43:753-758.
[12]李岩.弥散张量成像在急性大脑中动脉供血区脑梗死患者预后中的应用[D].河北大学,2015.
[13]庞冉,赵晶,张允岭,等.基于脑白质疏松的血管源性轻度认知障碍D T I研究[J].实用放射学杂志,2014,13(7):1071-1074.
[14]朱文珍,漆剑频,王伟.磁共振扩散成像和波谱技术对超急性脑梗死缺血半暗带的界定[J].华中科技大学学报(医学版),2007,36(5):691-694.
[15]马凌云,李乐才,李迎春,等.急性脑梗死的1HMRS波谱分析[J].实用临床医学,2007,8(1):103-111.
[2]张若楠.3D-ASL、DTI、DWI序列联合应用对缺血性脑梗死缺血半暗带的诊断价值[D].内蒙古医科大学,2016.
[3]王欣,尹俊雄,霍晓丽,等.磁共振波普联合表观弥散系数与灌注加权成像联合D W I评价急性脑梗死后缺血半暗带的比较研究[J].临床神经病学杂志,2015,28(6),401-403.
[4]李伟,龙晚生,罗学毛,等.弥散加权成像联合磁共振波谱分析在脑梗死中的应用研究[J].生物医学工程学进展,2011,32(3),155-161.
[5]黄强辉.探讨双源CT灌注成像对缺血性脑卒中半暗带的变化与临床预后的关系[D].南昌大学,2015.
[6]温家华.全脑CT灌注成像快速评价脑梗死核心及缺血半暗带研究[D].重庆医科大学,2015.
[7]Lou Xin,Yu Songlin,Scalzo Fabien,Starkman Sidney,Ali Latisha K,Kim Doojin,Rao Neal M,Hinman Jason D,Vespa Paul M,Jahan Reza,Tateshima Satoshi,Gonzalez Nestor R,Duckwiler Gary R,Saver Jeffrey L,Yoo Bryan,Salamon Noriko,Lyu Jinhao,Ma Lin,Wang Danny Jj,Liebeskind David S.Multi-delay ASL can identify leptomeningeal collateral perfusion in endovascular therapy of ischemic stroke.[J].Oncotarget,2017,8(2).
[8]Hanne M.M.Rooijackers,Evita C.Wiegers,Cees J.Tack,Marinette van der Graaf,Bastiaan E.de Galan.Brain glucose metabolism during hypoglycemia in type1 diabetes:insights from functional and metabolic neuroimaging studies[J].Cellular and Molecular Life Sciences,2016,73(4).
[9]余乐熺,秦彤,王亚瑟,等.ADC及rADC值对缺血性脑梗死缺血半暗带的诊断价值[J].放射学实践,2015,30(9):928-931.
[10]曲鑫鑫,孙洪赞,朱文珍,等.DWI联合动脉自旋标记及MRA评价脑梗死缺血半暗带[J].中国医学影像技术,2014,30(1):11-15.
[11]Hernandez DA,Bokkers RP,Mirasol RV,et al.Pseudocontinuous arterial spin labeling quantifies relative cerebral blood flow in acute stroke.Stroke,2012,43:753-758.
[12]李岩.弥散张量成像在急性大脑中动脉供血区脑梗死患者预后中的应用[D].河北大学,2015.
[13]庞冉,赵晶,张允岭,等.基于脑白质疏松的血管源性轻度认知障碍D T I研究[J].实用放射学杂志,2014,13(7):1071-1074.
[14]朱文珍,漆剑频,王伟.磁共振扩散成像和波谱技术对超急性脑梗死缺血半暗带的界定[J].华中科技大学学报(医学版),2007,36(5):691-694.
[15]马凌云,李乐才,李迎春,等.急性脑梗死的1HMRS波谱分析[J].实用临床医学,2007,8(1):103-111.