磁共振扩散加权成像与动脉自旋标记在急性脑血管病诊断中的应用价值

Application Value of Diffusion Weighted Imaging and Arterial Spin Labeling in Diagnosis of Acute Cerebrovascular Disease

目的探讨磁共振扩散加权成像(DWI)与动脉自旋标记(ASL)在急性脑血管病诊断中的应用价值。方法对2012年4月至2014年4月于我院接受治疗的26例急性脑血管病患者行常规的MRI、DWI以及ASL检查,分别对DWI和ASL上显示的病变面积大小、病变的信号特征等进行分析。结果 26例患者病灶中心ADC=(0.373±0.081)×10-3 mm2/s,健侧相应部位ADC=(0.807±0.073)×10-3mm2/s,两者相比较差异明显(P<0.05)。同一时间段的病灶中心ADC值与其健侧相对应部位的ADC值之间也有统计学意义(P<0.05)。26例患者中,CASL-PWI低灌注区大于DWI异常信号区的有15例(其中有2例患者无SWI异常信号),小于DWI异常信号区的有10例,面积相同的有1例。结论采用ASL检查时无需对患者进行对比剂的注射,操作简易,但其对部分急性或亚急性脑梗死检出率存在偏差,配合DWI可准确地诊断急性期脑梗死,DWI和ASL的结合使用在早期的急性脑血管病的诊断中具有重要的价值。

Objective To investigate the application value of diffusion weighted imaging （DWI） and arterial spin labeling （ASL） in diagnosis of acute cerebrovascular disease （ACVD）. Methods 26 cases of ACVD patients treated in our hospital from April 2012 to April 2014 were selected and received routine examination of MRI, DWI and ASL. The proportion and signal features of lesion revealed through DWI and ASL were analyzed. Results The ADC of the lesion center was （0.373 ± 0.081） × 10.3 mm2/s, significantly lower than （0.807± 0.073） × 10-3 mm2/s of the relevant part of the uninjured side, with statistical significant difference （P 〈0.05）, the ADC between lesion center and the relevant part of the uninjured side at the same period had statistical significant difference （P 〈0.05）. Among 26 patients, 15 patients＇ hypoperfusion area were larger than abnormal signal area of DWI （2 cases had no abnormal signal of SWI）, 10 patients＇ hypoperfusion area were less than abnormal signal area of DWI, the hypoperfusion area of the remaining 1 patient was equal to the abnormal signal area of DWI. Conelusions ASL examination is easy to operate for most patients not needing contrast agent injection, but it will produce some deviations on the detection rate of patients with acute and subacute cerebral infarction. ASL coordinated with DWI can accurately diagnose acute cerebral infarction. The application of DWI combined with ASL has great value in diagnosis of inchoate acute cerebral infarction.