摘要
目的分析急性脑梗死患者磁共振弥散张量成像(DTI)的参数变化,探讨其在脑梗死中的应用价值。方法45例急性脑梗死患者根据病程分为:超早期组(〈12h)7例,急性期组(12~24h)18例,亚急性期组(〉1~7d)20例。应用Siemens AVANTO1.5T磁共振机行头颅常规磁共振成像(MRI)、弥散加权成像(DWI)及DTI检查,测量各期病灶中心区与周边区部分各向异性(FA)、表观弥散系数(ADC)的变化,并与梗死对侧进行对比。结果急性期病灶中心区与周边区FA值分别为0.318±0.057VS0.398±0.055(P〈0.01),亚急性期病灶中心区与周边区FA值分别为0.305±0.035VS0.309±0.029(P〈0.01);超早期中心区与周边区的ADC值分别是(0.291±0.051)×10^-3mm^2/sVS(0.390±0.050)×10^-3mm^2/s(P〈0.01);急性期的中心区与周边区ADC值分别是(0.379±0.018)×10^-3mm^2/sVS(0.479±0.016)×10^-3mm^2/s(P〈0.01)。随着病情进展,梗死灶FA值逐渐下降,急性期梗死侧和梗死对侧的FA值分别是0.342±0.050VS0.461±0.079(P〈0.01),亚急性期梗死侧和梗死对侧的FA值分别是0.305±0.029VS0.480±0.059(P〈0.01);梗死灶ADC值随病程进展先下降再升高,超早期梗死侧和梗死对的ADC值(0.344±0.023)×10^-3mm^2/sVS(0.663±0.033)×10^-3mm^2/s(P〈0.01);急性期梗死侧和梗死对侧的ADC值分别是(0.432±0.018)×10^-3mm^2/sVS(0.678±0.026)×10^-3mm^2/S(P〈0.01)。结论FA、ADC联合应用能更精确地对急性脑梗死进行分期和定位;并对缺血半暗带的判断有重要价值。
Objective To analyze the characteristics of magnetic resonance diffusion tensor imaging(DTI) and to explore the values of DTI in patients with acute cerebral infarction. Methods Forty-five patients with acute cerebral infarction were classified in three groups according to the course: hyperacute group(G12 h, n = 7) ,acute group (12- 24 h, n = 18),and subacute group(〉 1- 7 d, n = 20). Conventional magnetic resonance imaging(MRl) and diffusion weighed imaging(DWI), DTI were performed by the Siemens Tim-avanto 1.5 T using a standard. The values of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured in the infarcted regions, corresponding contralateral regions, and in the infarcted cores and peripheral parts. Results FA values of infarcted core and surround area were 0. 318±0. 057 vs 0. 398±0. 055(P〈0.01) in acute period and 0. 305±0. 035 vs 0. 309± 0. 029( P 〈0.01) in subacute period; ADC values of infarcted core and surrounding area were (0. 291±0. 051) × 10^-3 mm^2/s vs (0. 390 ± 0. 050) × 10^-3 mm^2/s( p 〈0.01) in hyperacute period and (0. 379 ± 0. 018) × 10^-3 mm^2/s vs (0. 479±0. 016) × 10^-3mm^2/s( P 〈0.01) in acute period. With the course progressing,FA decreased gradually, FA values of infarcted side and contralateral side were 0. 342±0. 050 vs 0. 461 ±0. 079( P 〈0.01) in acute period and 0. 305±0. 029 vs 0. 480±0. 059( P 〈0.01) in subacute period; ADC of infarcted side declined first and then increased, ADC values of infarcted side and contralateral side were (0. 344 ± 0.023) × 10^-3 mm^2/s vs (0. 663 ± 0. 033) × 10^-3 mm^2/s( P 〈0.01) in hyperacute period and (0. 432 ± 0. 018) × 10^-3 mm^2/s vs (0. 678 ± 0. 026) × 10^-3 mm^2/s ( P 〈 0.01) in acute period. Conclusion The combination of FA and ADC may assist clinical stage and evaluate the existence of ischemic penumbra more accurately after acute stroke.
出处
《临床荟萃》
CAS
北大核心
2008年第20期1463-1466,F0003,共5页
Clinical Focus
关键词
脑梗塞
磁共振成像
弥散
诊断
鉴别
brain infarction
diffusion magnetic resonance imaging
diagnosis, differential