眩晕患者基底动脉血流动力学3．0T磁共振研究

Basilar artery hemodynamics quantitative analysis of the patients with vertigo by 3. 0 T MR

目的应用3．OTMR探讨眩晕患者基底动脉及其供血区脑组织血流动力学情况。方法临床表现为眩晕者及正常志愿者各50例。所有受试者均行颅脑磁共振成像（MRI）、磁共振血管成像（MRA）、快速电影相位对比（FastCINEPC）及流动敏感交互式反转恢复序列（FAIR）检查，对图像进行后处理，得出流速并计算血流量。测量两侧枕叶、小脑、脑桥、延髓FAIR值。对结果进行统计学分析。结果病例组基底动脉平均流速、峰值流速及血流量分别为（22．47±9．14）、（31．60±13．18）cm／s及（91．14±43．92）ml／min，对照组基底动脉平均流速、峰值流速及血流量分别为（31．41±5．97）、（44．00±7．84）cm／s及（127．49±28．33）ml／min，以上3项指标病例组均较对照组低，两组比较差异均有统计学意义（平均流速：t=-5．79，P〈0．0001；峰值流速：t=-5．71，P〈0．0001；血流量：t=-4．92，P〈0．0001）；病例组、对照组基底动脉供血区脑组织灌注总值分别为882．35±35．22、906．34±36．82，两组比较差异有统计学意义（t=-3．3分，P=0．0012）。MR扫描脑实质及脑血管无明显异常的眩晕患者基底动脉平均流速、峰值流速及血流量分别为（26．31±5．16）、（36．33±6．60）cm/s及（95．38±28．16）ml／min，亦均较对照组低（平均流速：t=-2．72，P=0．0086；峰值流速：t=-3．12，P=0．0027；血流量：t=-3．53，P=0．0008）；MR扫描脑实质及脑血管无明显异常的眩晕患者基底动脉供血区脑组织灌注总值为904．00±35．82，与对照组（906．34±36．82）比较差异无统计学意义（t=-0．20，P=0．8427）。结论无论脑实质及脑血管有无缺血性病变，眩晕患者基底动脉血液流速及流量均减低；而基底动脉供血区脑组织灌注情况则因有无缺血性病变而不同。

Objective To investigate the hemodynamics of basilar artery and its blood-supply area in patients with vertigo by 3.0 T MR. Methods Fifty patients with vertigo were selected as case group and 50 healthy volunteers were selected as control group. All subjects in the case group and in control group were examined by brain magnetic resonance imaging （MRI）, magnetic resonance angiography（ MRA）, fast cine phase contrast（ Fast CINE PC ） and flow-sensitive alternating inversion recovery sequence （FAIR）. After image postprocessing, the velocity and the blood flow volume of basilar artery were measured and calculated. The FAIR value of bilateral occipital lobe, cerebellum, pans and medulla oblongata was measured. Statistical testing was performed. Results The average velocity, peak velocity and blood flow volume of the basilar artery in case group were significantly lower than those in the control group （the average velocity： （22.47 ±9. 14） cm/s vs （31.41 ± 5. 97） cm/s, t = - 5. 79, P 〈 O. 0001 ; peak velocity： （31.60 ± 13. 18 ） cm/s vs （44. 00 ± 7. 84） cm/s, t = - 5.71 ,P 〈0. 0001 ;blood flow volume： （91.14 ±43.92） ml/min vs （ 127.49 ±28.33） ml/min,t = -4. 92 ,P 〈 O. 0001 ）. The perfusion of the posterior circulation in the case group was lower than that in the control group （ （882. 35 ± 35.22） vs （906. 34 ± 36. 82）, t = - 3.33, P = 0. 0012）. The average velocity, peak velocity and blood flow volume of the basilar artery in case group whose brain parenchyma and blood vessels were normal were （26. 31 ±5.16） cm/s, （36. 33 ±6. 60） cm/s, （95.38 ±28. 16） ml/min respectively,which were all less than those in the control group （ average velocity ： t = - 2.72, P = 0. 0086 ; peak velocity： t = - 3.12, P = 0. 0027 ; blood flow volume ： t = - 3.53, P = 0. 0008 ）. The perfusion of the basilar artery blood-supply area in case group whose brain parenchyma and blood vessels were normal was （ 904.00 ± 35.82 ） , there was no difference when compared with the control group （906. O0 ± 36. 82, t = - 0. 20, P = 0. 8427）. Conclusion Whether the brainparenchyma and blood vessels is normal or not, the velocity and blood flow volume of the basilar artery in patients with vertigo are decreased, but the perfusion of the basilar artery blood-supply area are different, it depends on whether there is ischemia.