磁共振灌注加权成像在肝豆状核变性诊断中的应用

Application of MR Perfusion Weighted Imaging in the Diagnosis of Brain Wilson Disease

目的探讨MR灌注加权成像(perfusion weighted imaging,PWI)在肝豆状核变性(hepatolenticular degener-ation,HLD)诊断中的应用价值。资料与方法对30例临床诊断为HLD的患者及对照组25例行常规颅脑MRI,以及注射对比剂(Gd-DTPA)后采用自旋回波-回波平面成像(SE-EPI)序列MRPWI检查。通过工作站重组相对局部脑血容量(rCBV)图、局部脑血流量(rCBF)图及对比剂平均通过时间(rMTT)图。计算每例受试者的豆状核及丘脑等HLD患者脑病变易发区域的rCBV、rCBF及rMTT相对值,比较HLD患者组和对照组之间的rCBV、rCBF及rMTT相对值差别。结果常规MRI异常信号(多为长T1、长T2信号)最常见于HLD患者的豆状核及丘脑等部位。PWI显示HLD患者组的rCBV、rCBF均值较对照组低。结论MR脑血流灌注图和半定量分析有助于观察HLD患者病变区的血流动力学改变,与常规MRI结合可同时反映HLD患者脑病变的部位、形态和功能变化。

Objective To discuss the application value of MR perfusion imaging in the diagnosis of brain Wilson disease. Materials and Methods 30 patients with Wilson disease and 25 controls received conventional MRI and PWI（Perfusion weighted imaging） examinations. Reconstructed parameter maps of relatively cerebral blood volume （rCBV）, relatively cerebral blood flow （rCBF） and relatively mean transit time （rMTT） in the interesting regions of brain, such as putamina and thalamencephalon were calculated for all subjects. T-test was used to analyze the differences of rCBV, rCBF and rMTT between two groups. Results In patients with Wilson disease, the highest prevalence of MRI abnormal signal intensity was observed in putamina （ 93.3% ）, followed by thalamencephalon, caudate nucleus and etc. Compared to control group, the patients with Wilson disease had significantly lower rCBV and rCBF both in putamina and thalamencephalon than that of control group. Conclusion Brain MRI abnormal signal intensity in putamina and thalamencephalon can be depicted in patients with Wilson disease. PWI combined with conventional MRI can reflect the changes in location, shape and function.