上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

体素内不相干运动成像与三维动脉自旋标记成像评估缺血性脑梗死脑血流灌注的对比研究

俎金燕1,2,所世腾1,2,周子恩1,2,蔡瑾1,2,李俊1,2,邹爱华1,2,朱婉秋3,陈增爱1,2,李磊1,2,许建荣1,2   

  1. 1.上海交通大学 医学院附属仁济医院南院放射科， 上海 201112； 2.上海交通大学 医学院附属仁济医院放射科, 上海 200127； 3.安徽医科大学第一附属医院放射科, 合肥 230022
  • 出版日期:2015-12-28 发布日期:2016-01-21
  • 作者简介:俎金燕（1979—）， 女， 住院医师， 硕士生; 电子信箱: 29491436@qq.com。
  • 基金资助:

    上海交通大学医工交叉基金面上项目 （YG2014MS50）；上海市卫计委面上项目（201540231）；上海交通大学医学院附属仁济医院南院科研启动基金（2014QDM12）

Comparative study on evaluating brain perfusion of patients with ischemic stroke by intravoxel incoherent motion perfusion imaging and three-dimension arterial spin labeling imaging

ZU Jin-yan1,2, SUO Shi-teng1,2, ZHOU Zi-en1,2, CAI Jin1,2, LI Jun1,2, ZOU Ai-hua1,2, ZHU Wan-qiu3, CHEN Zeng-ai1,2, LI Lei1,2, XU Jian-rong1,2   

  1. 1.Department of Radiology, Renji Hospital South Campus, Shanghai Jiao Tong University School of Medicine, Shanghai 201112, China； 2.Department of Radiology， Renji Hospital， Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China； 3.Department of Radiology, First Affiliated Hospital of Anhui Medical University， Hefei 230022, China
  • Online:2015-12-28 Published:2016-01-21
  • Supported by:

    Biomedical Engineering Cross Research Foundation of  Shanghai Jiao Tong University， YG2014MS50； Foundation of Shanghai Municipal Commission of Health and Family Planning， 201540231； Scientific Research Initial Foundation of Renji Hospital South Campus， Shanghai Jiao Tong University School of Medicine, 2014QDM12

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摘要：

目的  对比分析体素内不相干运动成像（IVIM-MRI）与三维动脉自旋标记成像（3D-ASL）在评价缺血性脑梗死后脑血流灌注改变中的临床应用价值。方法  46例缺血性脑梗死患者分别行常规MRI、弥散加权成像（DWI）、3D-ASL和IVIM-MR检查。以DWI显示的梗死灶和镜像对照区作为感兴趣区，3D-ASL分别测量双侧局部脑血流量（CBF）变化。IVIM测量参数有表观扩散系数（ADC）、灌注分数（f）、假扩散系数（D*）以及扩散系数（D），将患侧与健侧参数进行配对t检验。同时计算所有参数的相对值 (r=脑梗死区/健侧镜像区)，同时将IVIM各参数相对值改变（rADC、rf、rD*、rD）分别与rCBF进行Spearman相关性分析。结果  梗死区CBFASL较对侧减低，两者差异有统计学意义（P<0.05）。梗死区ADC、f值、D值与健侧比较的差异有统计学意义（P<0.05）。梗死区D*值较健侧减低，但差异无统计学意义（P>0.05）。除rD*外，梗死区rADC、rD、rf与rCBF的相关性具有统计学意义（P<0.05）。结论  IVIM-MR和3D-ASL在检出缺血性脑梗死患者的脑血流灌注改变方面具有一致性，可用于评价缺血性脑梗死后血流灌注改变，有利于指导临床。

关键词: 动脉自旋标记成像, 脑血流量, 磁共振, 体素内不相干运动成像

Abstract:

Objective  To compare and analyze the clinical application value of intravoxel incoherent motion perfusion imaging MRI (IVIM-MRI) and three-dimension arterial spin labeling (3D-ASL) imaging for evaluating changes of brain perfusion of patients with ischemic stroke. Methods  A total of 46 patients with ischemic stroke underwent routine MRI with DWI, 3D-ASI, and IVIM. Stroke areas indicated by DWI and contralateral normal areas were selected as regions of interest and changes of bilateral local cerebral blood flow (CBF) were measured by 3D-ASL. Parameters measured by IVIM were apparent diffusion coefficient (ADC), diffusion coefficient of pure diffusion (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f). Paired t test was performed for stroke areas and contralateral areas. The relative values of all parameters were also calculated (r=stroke area/contralateral area). Spearman correlation analysis was performed for changes of relative values (rADC, rf, rD*, and rD) of parameters of IVIM and rCBF. Results  The CBFASL of stroke areas was lower than that of contralateral areas and the difference was significant (P<0.05). The differences of ADC, f, and D* between stroke areas and contralateral areas were significant (P<0.05). The D* of stroke areas was lower than that of contralateral areas and the difference was not statistically significant (P<0.05). Except rD*, the differences between rADC, rD, and rf of stroke areas and rCBFASL were statistically significant (P<0.05). Conclusion  The results of IVIM-MRI and 3D-ASL for the diagnosis of changes of brain perfusion of patients with ischemic stroke are consistent, which can be used for evaluating changes of brain perfusion after the incidence of ischemic stroke and are helpful for clinical diagnosis and treatment.

Key words: arterial spin labeling, cerebral blood flow, magnetic resonance imaging, intravoxel incoherent motion imaging