MR灌注与弥散加权成像不同匹配与急性脑梗死降纤治疗效果的关系

Relationship between different matching of MR perfusion and diffusion weighted imaging and curative effects of defibrase treatment in acute cerebral infarction

目的探讨MR灌注加权成像(PWI)与弥散加权成像(DWI)(PWI/DWI)不同匹配与急性脑梗死降纤治疗效果的关系。方法给38例急性脑梗死患者行巴曲酶降纤治疗,在治疗前予以MR PWI及DWI检查,在治疗前和治疗后进行美国国立卫生研究院卒中量表(NIHSS)评分并评定疗效。比较PWI/DWI不同匹配患者治疗前后的NIHSS评分;采用Spearman等级相关分析对PWI/DWI不同匹配(PWI>DWI、PWI/DWI正常、PWI<DWI、PWI=DWI)与降纤治疗效果(基本痊愈、显著进步、进步、无变化、恶化)的关系进行分析。结果本组患者中PWI>DWI 20例、PWI=DWI 11例、PWI<DWI 4例、PWI/DWI正常3例。PWI>DWI组、PWI/DWI正常组治疗后NIHSS评分比治疗前显著降低(P<0.001,P=0.003),而PWI<DWI组和PWI=DWI组治疗前后NIHSS评分比较,差异无统计学意义(P=0.080,P=0.229)。Spearman等级相关分析显示,PWI/DWI不同匹配与降纤治疗效果呈正相关(r=0.733,P<0.001)。结论 MR PWI/DWI不同匹配与急性脑梗死降纤治疗效果有显著关系,PWI>DWI和PWI/DWI正常的患者降纤治疗的效果较好,而PWI=DWI及PWI<DWI患者降纤治疗无明显效果。PWI/DWI匹配状况可用于指导脑梗死的降纤治疗。

Objective To investigate the relationship between different matching of MR perfusion weighted imaging（PWI） and diffusion weighted imaging（DWI）（PWI/DWI） and curative effects of defibrase treatment in acute cerebral infarction（ACI）.Methods Thirty-eight ACI patients were treated with Batroxobin.Before the treatment,they were detected by MR PWI and DWI.The National Institutes of Health Stroke Scale（NIHSS） was scored before and after treatment,and the curative effects were evaluated.The NIHSS scores of different matching of PWI/DWI before and after treatment were compared.Spearman rank correlation analysis was used to analyze the relationship between different matching of MR PWI/DWI（PWIDWI,PWI/DWI normal,PWIDWI,PWI=DWI） and curative effects of defibrase treatment（basic recovery,marked progress,progress,unchanged,deterioration）.Results In this group,there were 20 cases with PWIDWI,11 cases with PWI=DWI,4 cases with PWIDWI and 3 cases with PWI/DWI normal.The NIHSS scores in PWIDWI group and PWI/DWI normal group after treatment were significantly lower than before treatment（P0.001,P=0.003）,while there was no significant difference in PWIDWI group and PWI=DWI group between before and after the treatment（P=0.080,P=0.229）.Spearman rank correlation analysis showed that the different matching of PWI/DWI were positively correlated with the curative effects of defibrase treatment（r=0.733,P0.001）.Conclusions The different matching of MR PWI/DWI are significantly related to the curative effects of defibrase treatment in ACI.The curative effects of defibrase treatment in PWIDWI group and PWI/DWI normal group are great,while in PWIDWI group and PWI=DWI group are not so good.The matching of PWI/DWI may be used to guide the defibrase treatment.