SWI、DWI联合3D-ASL在缺血性脑卒中溶栓治疗中的应用
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摘要
目的探讨SWI、DWI、3D-ASL联合应用对评价缺血性脑卒中溶栓治疗的价值。方法选取2017年6月—2018年6月收治的缺血性脑卒中患者30例为实验对象,进行3D-ASL灌注和SWI、DWI加权成像,观察其影像学表现与溶栓治疗效果、溶栓出血和复发的关系。结果所有患者在3D-ASL灌注和SWI、DWI加权成像指导下进行溶栓治疗,出血率为3. 3%,再复发率为10. 0%,均为3D-ASL低灌注且ASL面积高于DWI面积,半暗带组织面积较大者。结论 SWI、DWI联合3D-ASL评估能够对缺血性梗死部位、面积进行准确判断,指导医生进行溶栓治疗,降低治疗后出血和复发的风险。
Objective: To explore the value of combined application of SWI,DWI and 3 D-ASL in the evaluation of thrombolytic therapy for ischemic stroke. Methods: Thirty patients with ischemic stroke admitted from June 2017 to June 2018 were studied by 3 D-ASL perfusion,SWI and DWI weighted imaging,and the relationship between thrombolytic bleeding and recurrence,the imaging findings and thrombolytic effects were observed. Results: All patients were treated with thrombolytic therapy under the guidance of 3 D-ASL perfusion and SWI and DWI weighted imaging. The bleeding rate was 3. 3%. The recurrence rate was 10. 0%. The area of ASL was higher than that of DWI and the area of ASL was larger than that of DWI. Conclusion:The evaluation of 3 D-ASL combined with WSI DWI can accurately judge the location and area of ischemic infarction,direct the doctor to carry out thrombolytic therapy,and reduce the risk of hemorrhage and recurrence after treatment.
Objective: To explore the value of combined application of SWI,DWI and 3 D-ASL in the evaluation of thrombolytic therapy for ischemic stroke. Methods: Thirty patients with ischemic stroke admitted from June 2017 to June 2018 were studied by 3 D-ASL perfusion,SWI and DWI weighted imaging,and the relationship between thrombolytic bleeding and recurrence,the imaging findings and thrombolytic effects were observed. Results: All patients were treated with thrombolytic therapy under the guidance of 3 D-ASL perfusion and SWI and DWI weighted imaging. The bleeding rate was 3. 3%. The recurrence rate was 10. 0%. The area of ASL was higher than that of DWI and the area of ASL was larger than that of DWI. Conclusion:The evaluation of 3 D-ASL combined with WSI DWI can accurately judge the location and area of ischemic infarction,direct the doctor to carry out thrombolytic therapy,and reduce the risk of hemorrhage and recurrence after treatment.
引文
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[11]余剑波,黄文凤,朱继红,等.急诊医生决策静脉溶栓治疗缺血性脑卒中的疗效及安全性评价[J].中国全科医学,2016,19(8):954-957.
[2]Andrew Bivard,Venkatesh Krishnamurthy,Peter Stanwell,et al.Arterial Spin Labeling Versus Bolus-Tracking Perfusion in Hyperacute Stroke[J].Stroke,2014,45:127-133.
[3]常飞燕,谢晟,李中实,等.利用三维伪连续脉冲动脉自旋标记测量颈性眩晕相关的脑血流量改变的初步研究[J].中华放射学杂志,2014,48(2):129-135.
[4]王丽娟,刘玉波,王光彬.磁敏感加权成像原理概述[J].磁共振成像,2010,1(3):227-230.
[5]Xiujuan Wu,Song Luo,Ying Wang,et al.Use of susceptibilityweighted imaging in assessing ischemic penumbra:a case report[J].Medicine(Baltimore),2017,96(6):e6091.
[6]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[7]Huang P,Chen CH,Lin WC,et al.Clinical applications of susceptibility weighted imaging in patients with major stroke[J].JNeurol,2012,259(7):1426-1432.
[8]陈忠华,熊越,虞晓菁,等.MRI颅内高信号血管征与颈内动脉狭窄的相关性研究[J].中华放射学杂志,2014,48(7):539-543.
[9]王秋艳,荣梅,赵洪海.联合应用DWI与MRA在超急性期大面积脑梗死中的价值研究[J].河北医学,2014,36(2):197-199.
[10]潘曙明,刘佳福.急性缺血性脑卒中的溶栓治疗:急诊医学的新机遇[J].内科理论与实践,2012,7(1):20-22.
[11]余剑波,黄文凤,朱继红,等.急诊医生决策静脉溶栓治疗缺血性脑卒中的疗效及安全性评价[J].中国全科医学,2016,19(8):954-957.