动脉质子自旋标记与动态磁敏感对比增强法灌注成像在评价脑缺血患者脑部微循环中的临床对比应用

Comparison of arterial spin labeling and dynamic susceptibility contrast-enhanced perfusion weighted imaging in evaluating microcirculation of patients with cerebral ischemia

目的:对比研究动脉质子自旋标记(ASL)与动态磁敏感增对比增强灌注成像(DSC-PWI)在评价脑缺血患者脑部微循环中的应用。方法:一侧大脑中动脉明显狭窄或闭塞的脑缺血患者25例,均采用GE-D7503.0TMR行头部ASL和DSC-PWI检查,定性观察两种技术在脑缺血中的灌注表现;在病变区域与正常脑半球的镜像区域分别确定4个感兴趣区,测定脑血流量(CBF)值,并计算信号强度比(病变侧/对照侧)。结果:25例患者中,ASL显示灌注不足19例,灌注过度1例,灌注正常5例,DSC-PWI显示灌注不足14例,灌注过度1例,灌注延迟6例,灌注正常4例,两种方法结果一致19例,符合率为76.0%。ASL和DSC-PWI所测相对CBF比值分别为(0.462±0.130)和(0.428±0.120),2组相比,差异无统计学意义(t=0.750,P=0.465)。结论:无创性ASL在检测脑缺血脑血流量灌注异常时与DSC-PWI具有同样的敏感性。

Aim： To compare the clinical values of arterial spin labeling（ASL） and dynamic susceptibility contrast-enhanced perfusion weighted imaging （DSC-PWI） MRI in evaluating the brain microcirculation of patients with cerebral ischemia.Methods： A total of 25 cases of brain ischemia with unilateral middle cerebral artery stenosis were examined by GE-D750 3.0T MR,and ASL and DSC-PWI data were acquired.Four regions of interest（ROI） in the lesion area and the mirror area of the lesions were chosen separately,the signal strength was measured,and the signal intensity ratio （lesion side/control side） was calculated.Results： In the 25 patients,there were 19 cases of hypoperfusion,1 case of hyperperfusion,and 5 cases of normal perfusion according to ASL,and there were 14 cases of hypoperfusion,1 case of hyperperfusion,6 cases of delayed perfusion,and 4 cases of normal perfusion according to DSC-PWI （19 cases were consistent,and the cosistent rate was 76.0%）.Quantitative results showed that the signal intensity ratio was （0.462± 0.130） for ASL, （0.428±0.120） for DSC-PWI,and there was no significant difference between the 2 techniques（t=0.750,P=0.465） .Conclusion： Noninvasive ASL perfusion is as sensitive as DSC-PWI in detecting cerebral microcirculation.