基底动脉狭窄患者3.0TMR快速电影相位对比序列血流动力学变化研究

Analysis on the Changes of Hemodynamics of Patients with Basilar Artery Stenosis by 3.0T MR

目的探讨基底动脉狭窄患者基底动脉狭窄处及其狭窄远处供血区脑组织血流动力学情况。方法选取2010年3月—2011年3月我院经临床及磁共振血管造影(MRA)检查诊断为基底动脉狭窄、闭塞患者19例为病例组,另选取同期我院体检的健康者16例为对照组。受试者均行颅脑磁共振成像(MRI)、MRA,3.0T MR快速电影相位对比序列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,得出流速并计算出流量。测量两侧延髓、脑桥、小脑、枕叶FAIR值。对结果进行统计学分析。结果 19例基底动脉狭窄、闭塞患者中,16例患者有后循环供血区脑梗死,患者主要表现为头晕、肢体无力、言语不清等。病例组狭窄处和狭窄远处平均流速、峰值流速及血流量较对照组降低,差异均有统计学意义(P<0.05);狭窄处与狭窄远处平均流速、峰值流速及血流量比较,差异均无统计学意义(P>0.05)。病例组FAIR总值较对照组降低,差异有统计学意义(P<0.05)。其中,延髓、枕叶FAIR值较对照组降低,差异均有统计学意义(P<0.05);而脑桥、小脑FAIR值与对照组比较,差异均无统计学意义(P>0.05)。结论基底动脉狭窄会引起基底动脉狭窄处、狭窄远处血管相对正常血管内血液流速、流量及整个后循环供血区脑组织灌注值减低。

Objective To investigate the hemodynamics of stenosis area and its blood-supply area among patients with basilar artery stenosis.Methods 16 patients with basilar artery stenosis and 3 patients with basilar artery occlusion confirmed by MRA in our hospital from March 2010 to March 2011 were selected as case group,and meanwhile,16 healthy people were selected as the control group.All the cases in the two groups were given examinations of MRI,MRA,Fast CINE PC and FAIR.After image processing,the velocity and the blood flow volume of basilar artery were measured and calculated.The FAIR value of bilateral occipital lobe,cerebellum,pons and medulla oblongata were measured.The results were analyzed statistically.Results 16 out of the 19 patients had cerebral infarction in the posterior circulation blood supply areas,and their symptoms included dizzy,weakness,irrational speech and so on.There was statistically significant difference in the average velocity,peak velocity and blood flow volume of the basilar artery between the case group and the control group（P《0.05）,but there was no statistically significant difference in the average velocity,peak velocity and blood flow volume of the basilar artery between stenosis area and blood-supply area（P《0.05）.The total FAIR value of the posterior circulation in the case group was significantly lower than the control group（P《0.05）.The FAIR value of the medulla oblongata,occipital lobe was significantly lower than the control group（P《0.05）,but there was no statistically significant difference in the FAIR value of the pons,cerebellum compared with the control group（P《0.05）.Conclusion Basilar artery stenosis can lead to the decrease of velocity of blood flow and blood flow volume in the stenosis area and blood-supply area and the decrease of perfusion value of blood-supply area.