扩散张量成像和动脉自旋标记对急性缺血性脑卒中脑损伤的评价

Assessment of diffusion tensor imaging and arterial spin labeling in acute ischemic cerebral apoplexy brain damage

目的 3.0 T MR扩散张量成像(DTI)和动脉自旋标记(ASL)对急性缺血性脑卒中脑损伤的评价。材料与方法 25例确诊的急性缺血性脑卒中患者,其中超急性期5例、急性期16例和亚急性期4例,所有患者均行DTI及ASL检查,观察各期的DTI图像及ASL图像并通过特殊软件进行后处理,重建白质纤维束(DTT),测量梗死区与镜像区的FA值、ADC值及r CBF值,比较差异性并进行相关性分析。结果梗死灶FA值、ADC值及r CBF值均较镜像区脑组织明显降低(P<0.0 5),梗死区FA值、A D C值与r C BF值之间无明显相关(P>0.0 5);采用Spearman秩相关分别分析3个时期脑梗死区的FA值、ADC值和r CBF值均无明显差异。结论 DTI和ASL能够早期反映梗死灶血流灌注情况及该区白质纤维束的完整性,根据量化的数据,可以间接判断急性缺血性脑卒中脑损伤的时间,进而提高适合溶栓的患者人数,改善其生活质量。

Objective： To evaluate acute ischemic cerebral apoplexy brain damage by diffusion tensor imaging （DTI） and arterial spin labeling （ASL） at 3.0 T MRI. Materials and Methods： Twenty-five cases with acute ischemic cerebral apoplexy, there were 5 cases of superacute stage, 16 cases of acute stage and 4 cases of subacute stage. All patients underwent DTI and ASL imaging techniques. DTI and ASL images in every period were observed and performed post-processing using professional software to rebuild the corticospinal tract, and FA, ADC and rCBF values of the infarction and mirror areas of magnitude were measured. Difference of FA, ADC and rCBF values between infarction and mirror areas were analyzed by t-test. Correlation between FA, ADC and rCBF values was analyzed by multivariate partial correlation analysis. Results： FA, ADC and rCBF values of infarct areas in all patients were decreased evidently （P〈0.05）, correlation of FA, ADC and rCBF values in infarction area had no obvious significant difference （P〉0.05）. The Spearman rank correlation analysis of three periods respectively FA, MD and rCBF values of infarction areas were no obvious difference （P〉 0.05）. Conclusions： DT1 and ASL could reflect the situation infarcts perfusion early and the relationship between the infarction and white matter fiber bundles. DTI and ASL could be used to predict the degree of acute isschemic cerebral apoplexy brain damage.