CAJ | 학술논문

目的：探讨单、多相位动脉自旋标记(ASL)灌注技术的优缺点以及在脑卒中患者中的临床应用价值。方法对31例脑卒中患者行常规MRI、扩散加权成像(DWI)和单、多相位ASL检查。观察2种方法的灌注特点，包括低灌注、正常灌注、延迟灌注、高灌注等，比较2种方法各自的优势。分别在DWI、ASL上确定病变的范围，比较两者之间的关系。结果31例患者中，23例单、多相位ASL灌注结果完全一致(低灌注14例，低灌注伴局部高信号3例，高灌注4例，正常灌注2例)，8例灌注结果不完全一致，(2例单相位显示低灌注，多相位为延迟灌注；6例单相位显示低灌注，多相位为低灌注伴局部高信号)。30例脑卒中患者中，DWI与ASL对同一病例相同病变显示面积大小：SDWI<SASL，n=13；SDWI≈SASL， n=16；DWI阳性而ASL阴性，n=2。结论 ASL能基本反映脑梗死区的血流灌注情况，多相位ASL在显示脑卒中延迟灌注、局部高信号(提示侧枝循环)方面比单相位ASL更具优势，单相位ASL图像信噪比相对较高。
목적：탐토단、다상위동맥자선표기(ASL)관주기술적우결점이급재뇌졸중환자중적림상응용개치。방법대31례뇌졸중환자행상규MRI、확산가권성상(DWI)화단、다상위ASL검사。관찰2충방법적관주특점，포괄저관주、정상관주、연지관주、고관주등，비교2충방법각자적우세。분별재DWI、ASL상학정병변적범위，비교량자지간적관계。결과31례환자중，23례단、다상위ASL관주결과완전일치(저관주14례，저관주반국부고신호3례，고관주4례，정상관주2례)，8례관주결과불완전일치，(2례단상위현시저관주，다상위위연지관주；6례단상위현시저관주，다상위위저관주반국부고신호)。30례뇌졸중환자중，DWI여ASL대동일병례상동병변현시면적대소：SDWI<SASL，n=13；SDWI≈SASL， n=16；DWI양성이ASL음성，n=2。결론 ASL능기본반영뇌경사구적혈류관주정황，다상위ASL재현시뇌졸중연지관주、국부고신호(제시측지순배)방면비단상위ASL경구우세，단상위ASL도상신조비상대교고。
Objective To investigate the single, multi-phase ASL perfusion technique,analyze the application value in patients with cerebral ischemic infraction. Methods Routine MRI scanning、DWI、and single, multi-phase ASL were performed on 31 patients with acute ischemic stroke. Perfusion deficits, normal perfusion, delayed perfusion and hyperfusion were observed, compared advantages of 2 methods. Areas of infarction measured on DWI and ASL were compared.Results The two techniques demonstrated agreement in 23 of 31 patients (hypoperfusion, n=14; low perfusion with local high signal, n=3;normal perfusion, n=2; hyperfusion, n=4). 8 cases were not completely consistent, (8 cases of single-phase ASL showed low perfusion, 2 cases of multi-phase ASL showed delayed perfusion; 6 cases showed low perfusion with local high signal).The size of the same lesions in the same patient showed by DWI and ASL appeared: SDWI<SASL, n=13; SDWI≈SASL, n=16; 2 cases showed positive results on DWI and negative on ASL.Conclusion ASL can reflect the blood perfusion of cerebral infarction, multi-phase ASL in displaying delayed perfusion, local high signal (presented collateral circulation) has more advantages than single-phase ASL, single phase ASL image better SNR.