ASL联合SWI对急性脑梗死侧支代偿建立状态的评估价值

Evaluation of ASL combined with SWI on the establishment of collateral compensation in patients with acute cerebral infarction

目的初步探讨磁共振动脉自旋标记成像(ASL)联合磁敏感加权成像(SWI)在急性脑梗死侧支代偿储备评估中的应用价值。方法收集研究2014年10月-2016年4月经我院临床和影像证实的40例急性脑梗死患者,采用GE3.0T超导磁共振进行常规序列,ASL和SWI序列检查,观察分析ASL伪彩图,依据梗死核心区周围条形高灌注信号的出现与否,将患者分为侧支代偿储备组和对照组,分别对两组患者于入院当日及15日进行NIHSS评分。同时通过SWI观察侧支代偿储备组梗死核心区周围引流静脉形态变化。结果两组患者入院当日NIHSS评分差异无统计学意义(P>0.05),侧支代偿储备组患者入院当日与15日NIHSS评分好转率、稳定率及进展率分别为77.78%(14/18)、16.67%(3/18)、5.55%(1/18);对照组患者入院当日与15日临床NIHSS评分好转率、稳定率及进展率分别为是31.82%(7/22)、22.73%(5/22)、45.45%(10/22),两组15日NIHSS评分差异有统计学意义(P<0.05)。SWI提示侧支代偿储备组18例患者,梗死核心区周围引流静脉明显显示率为66.67(12/18),正常显示率为33.33%(6/18)。结论依据ASL提示梗死核心周围区域血液灌注信息,能够客观反映血液动力学改变,联合SWI能够更好评估侧支循环代偿储备建立状态,对于临床了解急性脑梗死患者缺血现状及短期预后评估提供依据,为制定个体化、精准化的治疗方案提供参考。

Objective To evaluate the value of magnetic resonance imaging （ ASL） combined with magnetic suscep-tibility weighted imaging （SWI） in the assessment of collateral reserve in patients with acute cerebral infarction .Methods October 2014 to 2016 4 periods in our hospital clinical and imaging confirmed 40 cases of patients with acute cerebral in-farction and conventional sequence ASL and SWI sequence were examined using standard superconducting magnetic reso -nance,observe and analyze ASL pseudo color pictures ,out in the infarct core area around the bar high perfusion signals now or not,the patients were divided into the collateral flow reserve group and control group on the basis of ,respectively,the two groups of patients at the admission day and 15 of NIHSS score analysis .At the same time,through the SWI observation of the collateral reserve group ,analysis of the central area around the infarction of the drainage vein display .Results Two groups of patients on the day of admission NIHSS scores were no statistical significance （ P〉0.05 ） and collateral flow reserve group of patients admitted to hospital on the same day and 15 NIHSS score improvement rate ,stable rate and progression rates were 77.78%（14/18）,16.67%（3/18）,5.55%（1/18）;the control group of patients admitted to hospital on the same day and 15 NIHSS scores improved rate,stable rate and rate of progression were 31.82%（7/22）,22.73%（5/22）, 45.45%（10/22） respectively,two groups of 15,NIHSS score difference has statistical significance （P〈0.05）.SWI sug-gested that 18 cases of collateral reserve group,the obvious display rate was 66.67（12/18）,the normal display rate was 33.33%（6/18）.Conclusion According to the ASL prompt infarct core area around the blood perfusion information ,can objectively reflect the hemodynamic changes ,combined with SWI can better evaluate the collateral circulation compensatory reserve establishment state for clinical acute cerebral infarction patients with ischemia of the status quo and short -term prog-nosis provide a basis to assess ,provide reference for the development of individual and accurate treatment plan.