CAJ | 학술논문

目的：分析磁共振三维动脉自旋标记成像（3D-ASL ）与动态磁敏感对比增强灌注成像（DSC-PWI）在急性缺血性脑梗死患者脑血流灌注状态诊断中的应用。方法22例缺血性脑梗死患者行常规MRI序列、DWI、MRA、3D-ASL及DSC-PWI检查。观察脑梗死患者的3D-ASL、DSC-PWI灌注后处理图像并进行评分（显示有高灌注记为＋1，未见明显灌注异常记为0，低灌注记为－1），并比较分析ASL-CBF 与PWI测量的CBF、CBV、MTT及Tmax之间的差异。结果22例中ASL显示灌注异常者有19例（86．3％），PWI-CBF、PWI-CBV、PWI-MTT及 PWI-Tmax 异常者分别为14例（63．6％）、12例（54．5％）、14例（63．6％）和16例（72．7％）。 Mc Nemar检验结果显示，ASL与PWI-CBF、PWI-CBV参数图在显示患者灌注差异有统计学意义（ P值分别为0．02、50．008）；除去在任意一种灌注图像上显示为高灌注的病例后，ASL-CBF与PWI各参量比较的P值分别为0．125、0．031、0．125、0．250，其中CBF、MTT及Tmax的差异无统计学意义（ P＜0．05）。结论作为一种无创性MRI灌注技术，ASL在临床应用中基本上能够较可靠地反映缺血性脑梗死患者的低灌注状态。
목적：분석자공진삼유동맥자선표기성상（3D-ASL ）여동태자민감대비증강관주성상（DSC-PWI）재급성결혈성뇌경사환자뇌혈류관주상태진단중적응용。방법22례결혈성뇌경사환자행상규MRI서렬、DWI、MRA、3D-ASL급DSC-PWI검사。관찰뇌경사환자적3D-ASL、DSC-PWI관주후처리도상병진행평분（현시유고관주기위＋1，미견명현관주이상기위0，저관주기위－1），병비교분석ASL-CBF 여PWI측량적CBF、CBV、MTT급Tmax지간적차이。결과22례중ASL현시관주이상자유19례（86．3％），PWI-CBF、PWI-CBV、PWI-MTT급 PWI-Tmax 이상자분별위14례（63．6％）、12례（54．5％）、14례（63．6％）화16례（72．7％）。 Mc Nemar검험결과현시，ASL여PWI-CBF、PWI-CBV삼수도재현시환자관주차이유통계학의의（ P치분별위0．02、50．008）；제거재임의일충관주도상상현시위고관주적병례후，ASL-CBF여PWI각삼량비교적P치분별위0．125、0．031、0．125、0．250，기중CBF、MTT급Tmax적차이무통계학의의（ P＜0．05）。결론작위일충무창성MRI관주기술，ASL재림상응용중기본상능구교가고지반영결혈성뇌경사환자적저관주상태。
Objective To analyze the cerebral blood flow perfusion status diagnosis in ischemic stroke patients by three-dimension arterial spin labeling imaging ( 3D-ASL ) and dynamic susceptibility contrast enhanced perfusion(DSC-PWI ).Methods Routine MRI with DWI, MRA,3D-ASL and DSC-PWI scan were performed in 22 patients with ischemic stroke.Observation of patients with cerebral infarction 3DA-SL and DSC-PWI perfusion image processing and score ( showed hyperperfusion is denoted by +1, no vision recorded as 0, hypoperfusion denoted as-1) , and a comparative analysis of the differences between ASL -CBF and PWI in measurement of CBF,CBV, MTT andTmax.Results 22patientsofASLperfusionabnormalin19cases(86.3%),PWI-CBF,PWI-CBV,andPWI-Tmax PWI-MTT abnormal respectively for 14 patients (63.6%), 12 patients (54.5%), 14 patients (63.6%) and 16 patients (72.7%).The MC nemar test results showed that ASL and PWI-CBF, PWI-CBV parameters in patients showed perfusion differences had statistical significance (P=0.025, 0.008, respectively).Remove display cases of hypererfusion, ASL-CBF and PWI parameters P were 0.125 ,0.031, 0.125, 0.250, where differences in CBF, MTT and Tmax no statistical significance ( P<0.05) .Con clusion As a noninvasive technique, ASL can basically in clinical application is reliable to reflect the hypoperfusion in patients with ischemic cerebral infarction.