IVIM-DWI与DCE-PWI在急性缺血性脑梗死中各灌注参数的相关性研究

Correlation Between IVIM-DWI and DCE-PWI Perfusion Parameters in Acute Ischemic Stroke

目的探讨急性缺血性脑梗死患者体素内不相干运动扩散加权成像(IVIM-DWI)与动态增强灌注加权成像(DCE-PWI)各灌注参数的相关性,评估IVIM-DWI反映急性缺血性脑梗死区灌注的能力。方法回顾性分析52例急性缺血性脑梗死患者的资料,所有患者均在发病后24~72 h内同时行IVIM-DWI、DCE-PWI检查。以IVIM-DWI图像(b=1000 s/mm2)为参照,在病灶最大层面及对侧镜像区域对称勾画感兴趣区(ROI)。获得病灶区及对侧镜像区的IVIM-DWI及DCE-PWI各定量参数值,并对各参数进行标准化(r=梗死灶/对侧镜像区)处理,获得各参数比值(rKtrans、rKep、rVe、rVp、rADC、rD、rD*、rf、rfD*)。对所得各参数比值进行Pearson相关性分析。结果rKtrans与rADC之间呈弱正相关(r=0.361,P=0.009),rVp与rf、rVp与rfD*之间呈较好的正相关(r值分别为0.675、0.720,P值均<0.001),fD*值较f值对缺血区灌注的变化更为敏感。结论IVIM-DWI与DCE-PWI部分灌注参数之间具有较好的相关性,提示IVIM-DWI在急性缺血性脑梗死中能够真实地反映灌注相关信息。

Objective To explore the correlation between intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI)and dynamic contrast-enhanced perfusion weighted imaging(DCE-PWI)perfusion parameters in acute ischemic stroke,and evaluating the ability of IVIM-DWI to reflect perfusion in ischemic stroke.Methods 52 patients with acute ischemic stroke who underwent IVIM-DWI and DCE-PWI at the same time within 24-72 hours after the onset of symptoms were enrolled in the study.Setting the images of IVIM-DWI(b=1000 s/mm2)as reference,Symmetric ROIs were drawn at the maximum level of the lesions and the contralateral mirror regions.Quantitative parameters of lesions and contralateral mirror areas derived from IVIM-DWI and DCE-PWI were measured.The relative values(rKtrans,rKep,rVe,rVp,rADC,rD,rD*,rf,rfD*)of brain infarction lesions and contralateral mirror areas were calculated.A correlation analysis of relative parameters was performed using Pearson correlation test.Results Positive correlations were found between rKtrans and rADC、rVp and rf as well as rVp and rfD*(r=0.361、0.675 and 0.720,P<0.05.fD*is more sensitive to the change of perfusionin ischemic lesions than f.Conclusion Partial perfusion parameters derived from IVIM-DWI and DCE-PWI have good correlations in acute ischemic stroke.The results suggest that IVIM-DWI can reliably reflect perfusion-related information.