中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2011年
3期
250-254
,共5页
惠丽红%肖江喜%谢晟%刘茜玮%莫大鹏%彭清%张晓东%何超%张珏%王霄英%蒋学祥
惠麗紅%肖江喜%謝晟%劉茜瑋%莫大鵬%彭清%張曉東%何超%張玨%王霄英%蔣學祥
혜려홍%초강희%사성%류천위%막대붕%팽청%장효동%하초%장각%왕소영%장학상
脑血管障碍%磁共振成像
腦血管障礙%磁共振成像
뇌혈관장애%자공진성상
Cerebrovascular disorders%Magnetic resonance imaging
目的 初步探讨梯度回波采样自旋回波序列(GESSE)评价慢性脑血管狭窄患者脑氧摄取分数(OEF)的价值,以及研究脑血流量(CBF)与OEF变化的相互关系.方法 选取8名正常志愿者及16例慢性单侧颈内动脉或颅内血管狭窄的患者,进行颅脑MR扫描,扫描序列包括T2WI、MRA、GESSE序列以及动脉自旋标记(ASL)序列.GESSE扫描得到的数据在Matlab软件下应用北京大学交叉学科研究院研发的后处理程序进行后处理得到OEF图,将双侧脑实质分别分为前、中、后共6个ROI,测量各个区域脑实质OEF值.ASL序列扫描数据也在该软件下进行后处理,选择与GESSE序列相同层面,并计算该层面上述ROI的CBF值,将患侧ROI的CBF与对侧对称ROI的CBF的比值定义为相对CBF(rCBF).将病变侧CBF值较对侧下降的ROI纳入研究范围.以rCBF=0.50为分割点,将所有研究范围内ROI的OEF值分为两组并采用t检验比较两者OEF值之间差异.正常志愿者的OEF值为标准,x-±2s为上下限范围,患者的OEF值与该范围进行比较.通过泊松相关分析检验rCBF与OEF的相关性.结果 8名正常志愿者平均脑组织OEF值为0.318±0.023,正常值上限为0.364,正常值下限为0.272.16例单侧血管狭窄的患者中,8例患者为单侧脑组织OEF值升高,共得到12个ROI,DSA或MRA上显示患者血管狭窄的情况为单侧多支血管狭窄或颅内主干血管多处狭窄.另外8例患者脑组织OEF值在正常范围内,共得到14个ROI,DSA或MRA上显示患者血管狭窄的情况为单支血管狭窄.以rCBF=0.50为分界点,将OEF值分为两组进行比较,rCBF≥0.50组的平均OEF值为0.325±0.028,rCBF＜0.50组的平均OEF值为0.397±0.010.两组之间的差异具有统计学意义(t=-8.840,P=0.000).相关分析发现rCBF与OEF之间存在负相关(r=-0.851,P=0.000).结论 慢性单侧颈内动脉和(或)颅内血管狭窄患者脑组织OEF值可能升高或在正常范围内,CBF值下降越明显,OEF值上升越明显.
目的 初步探討梯度迴波採樣自鏇迴波序列(GESSE)評價慢性腦血管狹窄患者腦氧攝取分數(OEF)的價值,以及研究腦血流量(CBF)與OEF變化的相互關繫.方法 選取8名正常誌願者及16例慢性單側頸內動脈或顱內血管狹窄的患者,進行顱腦MR掃描,掃描序列包括T2WI、MRA、GESSE序列以及動脈自鏇標記(ASL)序列.GESSE掃描得到的數據在Matlab軟件下應用北京大學交扠學科研究院研髮的後處理程序進行後處理得到OEF圖,將雙側腦實質分彆分為前、中、後共6箇ROI,測量各箇區域腦實質OEF值.ASL序列掃描數據也在該軟件下進行後處理,選擇與GESSE序列相同層麵,併計算該層麵上述ROI的CBF值,將患側ROI的CBF與對側對稱ROI的CBF的比值定義為相對CBF(rCBF).將病變側CBF值較對側下降的ROI納入研究範圍.以rCBF=0.50為分割點,將所有研究範圍內ROI的OEF值分為兩組併採用t檢驗比較兩者OEF值之間差異.正常誌願者的OEF值為標準,x-±2s為上下限範圍,患者的OEF值與該範圍進行比較.通過泊鬆相關分析檢驗rCBF與OEF的相關性.結果 8名正常誌願者平均腦組織OEF值為0.318±0.023,正常值上限為0.364,正常值下限為0.272.16例單側血管狹窄的患者中,8例患者為單側腦組織OEF值升高,共得到12箇ROI,DSA或MRA上顯示患者血管狹窄的情況為單側多支血管狹窄或顱內主榦血管多處狹窄.另外8例患者腦組織OEF值在正常範圍內,共得到14箇ROI,DSA或MRA上顯示患者血管狹窄的情況為單支血管狹窄.以rCBF=0.50為分界點,將OEF值分為兩組進行比較,rCBF≥0.50組的平均OEF值為0.325±0.028,rCBF＜0.50組的平均OEF值為0.397±0.010.兩組之間的差異具有統計學意義(t=-8.840,P=0.000).相關分析髮現rCBF與OEF之間存在負相關(r=-0.851,P=0.000).結論 慢性單側頸內動脈和(或)顱內血管狹窄患者腦組織OEF值可能升高或在正常範圍內,CBF值下降越明顯,OEF值上升越明顯.
목적 초보탐토제도회파채양자선회파서렬(GESSE)평개만성뇌혈관협착환자뇌양섭취분수(OEF)적개치,이급연구뇌혈류량(CBF)여OEF변화적상호관계.방법 선취8명정상지원자급16례만성단측경내동맥혹로내혈관협착적환자,진행로뇌MR소묘,소묘서렬포괄T2WI、MRA、GESSE서렬이급동맥자선표기(ASL)서렬.GESSE소묘득도적수거재Matlab연건하응용북경대학교차학과연구원연발적후처리정서진행후처리득도OEF도,장쌍측뇌실질분별분위전、중、후공6개ROI,측량각개구역뇌실질OEF치.ASL서렬소묘수거야재해연건하진행후처리,선택여GESSE서렬상동층면,병계산해층면상술ROI적CBF치,장환측ROI적CBF여대측대칭ROI적CBF적비치정의위상대CBF(rCBF).장병변측CBF치교대측하강적ROI납입연구범위.이rCBF=0.50위분할점,장소유연구범위내ROI적OEF치분위량조병채용t검험비교량자OEF치지간차이.정상지원자적OEF치위표준,x-±2s위상하한범위,환자적OEF치여해범위진행비교.통과박송상관분석검험rCBF여OEF적상관성.결과 8명정상지원자평균뇌조직OEF치위0.318±0.023,정상치상한위0.364,정상치하한위0.272.16례단측혈관협착적환자중,8례환자위단측뇌조직OEF치승고,공득도12개ROI,DSA혹MRA상현시환자혈관협착적정황위단측다지혈관협착혹로내주간혈관다처협착.령외8례환자뇌조직OEF치재정상범위내,공득도14개ROI,DSA혹MRA상현시환자혈관협착적정황위단지혈관협착.이rCBF=0.50위분계점,장OEF치분위량조진행비교,rCBF≥0.50조적평균OEF치위0.325±0.028,rCBF＜0.50조적평균OEF치위0.397±0.010.량조지간적차이구유통계학의의(t=-8.840,P=0.000).상관분석발현rCBF여OEF지간존재부상관(r=-0.851,P=0.000).결론 만성단측경내동맥화(혹)로내혈관협착환자뇌조직OEF치가능승고혹재정상범위내,CBF치하강월명현,OEF치상승월명현.
Objective Using gradient-echo sampling of spin-echo (GESSE) sequence to study the change of oxygen extraction fraction (OEF) in patients with unilateral cerebral vessel stenosis and the relationship between OEF and cerebral blood flow (CBF). Methods Eight normal volunteers and 16 patients with unilateral cerebral vessel stenosis were enrolled in this study. Written informed consents were obtained from all subjects. Routine MRI, GESSE and arterial spin labeling (ASL) sequences were performed for all patients. Raw data from GESSE and VE-ASL sequences were transferred to PC to conduct postprocessing. To obtain quantitative OEF and CBF of the brain parenchyma, 6 ROIs were placed respectively in the anterior, middle and posterior part of both hemispheres. The relative CBF (rCBF) was defined as the ratio of CBF of ischemic hemisphere to that of contralateral hemisphere. T test was used for statistics. Results The mean value and normal range of OEF in the volunteers were 0. 318 ± 0. 023 and 0. 272-0. 364, respectively. In the 16 patients with unilateral cerebral vessel stenosis, 8 patients had ROIs with greater OEF in unilateral hemisphere than those in contralateral hemisphere. These cases presented multiple intracranial main arterial stenoses in digital subtraction angiography (DSA) or MR angiography (MRA) examination. The other 8 patients had normal OEF in all ROIs. And they only had single arterial stenosis in DSA or MRA. Set rCBF = 0. 50 as a dividing point, the mean OEF value was 0. 397 ±0. 010 in the patients with rCBF ＜ 0. 50. In the patients with rCBF ≥ 0. 5, the mean OEF value was 0. 325 ±0. 028. The difference between the two groups was statistically significant (t = - 8. 840, P = 0. 000).Conclusion Patients with chronic cerebral ischemia may present with various hemodynamic impairment.The more CBF decreases, the more OEF increases. Those with increased OEF tended to have more than one lesion in the major intracranial arteries.
