CAJ | 학술논문

目的探讨脑梗死前期MR脑灌注成像的表现和分期临床应用价值.方法采用MR脑灌注成像对20例脑血管病患者的197层脑灌注图像和对照组20例非脑血管病患者的197层脑灌注成像进行分析,计算每层图像的患/健侧比值,并与对照组的正常比值及其范围比较.以非参数统计方法、多元方差分析和两两比较分析病例组和对照组脑灌注血流动力学参数及其分期.结果病例组和对照组的4个血流动力学参数差异均有统计学意义(P＜0.01).TTP(time to peak)和MTT(mean transit time)与发病的相关系数较高,分别为0.482和0.471,rCBV(regional cerebral blood volume)和rCBF(regional cerebral blood flow)较低,且为负值.脑梗死前期分期特征为:Ⅰ期一型TTP稍有延长,Ⅰ期二型MTT显著延长,Ⅱ期一型rCBF明显下降,Ⅱ期二型rCBV下降.结论 MR脑灌注成像可提供脑梗死前期的血流动力学参数变化的信息,并可以对其参数变化进行分期.
목적 탐토뇌경사전기MR뇌관주성상적표현화분기림상응용개치.방법 채용MR뇌관주성상대20례뇌혈관병환자적197층뇌관주도상화대조조20례비뇌혈관병환자적197층뇌관주성상진행분석,계산매층도상적환/건측비치,병여대조조적정상비치급기범위비교.이비삼수통계방법、다원방차분석화량량비교분석병례조화대조조뇌관주혈류동역학삼수급기분기.결과 병례조화대조조적4개혈류동역학삼수차이균유통계학의의(P＜0.01).TTP(time to peak)화MTT(mean transit time)여발병적상관계수교고,분별위0.482화0.471,rCBV(regional cerebral blood volume)화rCBF(regional cerebral blood flow)교저,차위부치.뇌경사전기분기특정위:Ⅰ기일형TTP초유연장,Ⅰ기이형MTT현저연장,Ⅱ기일형rCBF명현하강,Ⅱ기이형rCBV하강.결론 MR뇌관주성상가제공뇌경사전기적혈류동역학삼수변화적신식,병가이대기삼수변화진행분기.
Objective To explore clinical value of application to magnetic resonance(MR) perfusion imaging and stages of regional cerebral hypoperfusion in preinfarction period and improve the diagnosis level for pre-infarction period,and prevent or decrease the incidence of cerebral infarction. Methods 20 cases of cerebral ischemia in case group and 20 cases of non-cerebral ischemia in control group were performed with dynamic perfusion. 197 MR images of case group were compared with 197 images of control group,calculating the ratios of illness side to normal for every image at hypoperfusion areas in the regional cerebral isehemia and referring and comparing their range provided by control group with methods of nonparametrie statistics and multivariate analysis of variance and multiple comparison. Results Four parameters of blood flow dynamics between two groups showed a significant difference (P＜0.01). Correlation coefficients between time to peak(TTP) and time to peak(MTT) and incidence of regional cereberal hypoperfusion in pre-infarction period were higher,0. 482 and 0. 471 respectively, but regional cerebralblood volume(rCBV) and regional cerebralblood flow(CBF) were lower,and also negative. The characters of stages of regional cerebral hypoperfusion in pre-infarction period were as follows: stage Ⅰ 1 ,TTP delayed slightly; stage Ⅰ 2,MTT extended markedly;stage Ⅱ 1, rCBF dropped significantly;stage Ⅱ 2, rCBV decreased. Conclusion The information of regional cerebral hypoperfusion in pre-infarction period might be provided by MR cerebral perfusion and stages of preinfarction period could be designated with the change of blood flow dynamics parameters.