急性缺血性脑卒中多模态影像检查可行性研究

Feasibility Study of Multimodal Imaging for Acute Ischemic Stroke

目的急性缺血性脑卒中(AIS)患者CT平扫后行MR扩散加权成像(DWI)、三维时间飞跃法(3D-TOF)及动脉自旋标记(ASL)多模态影像检查模式构建并验证其可行性。方法搜集在本院确诊AIS患者发病4.5 h之内均行静脉溶栓76例,将其分为A组(仅行CT平扫)及B组(CT平扫后再行DWI、3D-TOF及ASL扫描)各38例,对比分析两组发病到影像科检查时间(DIT)、发病到静脉溶栓时间(ONT)、患者进入医院到静脉溶栓开始给药时间(DNT)及预后不良率(3个月后mRS评分>3分)等。结果B组的DNT及预后不良率分别为(30.78±2.18)分、24%均低于A组(50.17±8.01)分、53%,二组之间差异有统计学意义(P<0.05),其DIT、ONT、溶栓有效率、症状性脑出血及病死率两组之间差别无统计学意义(P>0.05)。结论AIS患者CT平扫后行DWI、3D-TOF及ASL多模态影像检查是可行的,不影响ONT及DNT,还可为患者治疗方案制定及预后评估提供形态结合功能较全面的影像信息。

Objective To construct and verify the feasibility of MR DWI,3 D-TOF and ASL multi-modal imaging examination modes after CT plain scan in patients with acute ischemic stroke(AIS).Methods Seventy-six cases were collected and treated with intravenous thrombolysis within 4.5 hours of the onset of AIS in our hospital.The patients were randomly divided into A group(Only plain CT scan was performed)and B group(DWI,3 D-TOF and ASL scanning were performed after plain CT scanning).DIT(examination time from onset to imaging department),ONT(time from onset to intravenous thrombolysis),DNT(time from patient’s admission to hospital to intravenous thrombolysis and administration),and poor prognosis rate(mR S score>3 after 3 months)were compared between the two groups.Results The DNT and poor prognosis rates of group B were(30.78±2.18)points,24%were lower than group A(50.17±8.01)points,53%,the difference between the two groups was statistically significant(P<0.05).There was no significant difference in DIT,ONT,effective rate of thrombolysis,symptomatic cerebral hemorrhage,and mortality between the two groups(P>0.05).Conclusion It is feasible to perform DWI,3 D-TOF and ASL multimodal imaging examinations after CT plain scan in AIS patients,and it does not affect the ONT and DNT time.It also provides comprehensive imaging information for the treatment plan and prognostic evaluation of patients.