基底动脉发育不全患者的脑干MR灌注成像

Magnetic Resonance Perfusion of Brain Stem in Patients with Basilar Artery Hypoplasia

目的应用MR灌注加权成像(PWI)分析基底动脉发育不全(BAH)患者的脑干血流动力学特点。资料与方法根据纳入标准和排除标准筛选BAH患者51例和非BAH患者79例,全部患者完成MRI、3D-TOF和PWI检查,经后处理获取磁共振血管成像,并测量桥脑局部脑血流量(r CBF)、局部脑血容量(r CBV)、局部平均通过时间(r MTT)、达峰时间(TTP)。结果 BAH组r CBF值[(17.10±6.52)ml/(100 g·min)]低于非BAH组[(29.06±13.32)ml/(100 g·min)](P<0.05);BAH组r CBV值[(1.41±0.26)ml]低于非BAH组[(2.62±0.82)ml](P<0.05);BAH组r MTT值[(6.14±1.31)s]高于非BAH组[(5.39±1.08)s](P<0.05);BAH组TTP值[(20.78±3.48)s]高于非BAH组[(19.01±2.39)s](P<0.05)。TTP是脑灌注损伤最敏感的指标,BAH组TTP延长发生率为41.18%。结论 PWI能及时发现BAH患者脑血流动力学异常,为在脑缺血区域尚未产生不可逆性损伤前及时进行治疗提供依据。

Purpose To analyze the hemodynamic characteristics of brain stem in patients with basilar artery hypoplasia（BAH） by magnetic resonance perfusion-weighted imaging（PWI）. Materials and Methods According to the inclusion and exclusion criteria, 51 patients with BAH were selected as the BAH group, and 79 patients without BAH were selected as the non BAH group. All patients were examined by MRI, 3D-TOF and PWI, and magnetic resonance angiography was acquired after the three examinations. The regional cerebral blood flow（r CBF）, regional cerebral blood volume（r CBV）, regional mean transit time（r MTT） and time to peak（TTP） values of pontine area were measured. Results The r CBF value of the BAH group [（17.10±6.52） ml/（100 g · min）] was significantly lower than that of the non BAH group [（29.06±13.32） ml/（100 g · min）]（P〈0.05）; the r CBV value of the BAH group [（1.41±0.26） ml] was significantly lower than that of the non BAH group [（2.62±0.82） ml]（P〈0.05）; the TTP value of the BAH group [（6.14±1.31） s] was significantly higher than that of the non BAH group [（5.39±1.08） s]（P〈0.05）; the r MTT value of the BAH group [（20.78±3.48） s] was significantly higher than that of the non BAH group [（19.01±2.39） s]（P〈0.05）. TTP was the most sensitive index of cerebral perfusion injury, and the incidence of TTP extension was 41.18% in the BAH group. Conclusion PWI can detect the abnormal cerebral hemodynamics in patients with BAH, which provides the basis for the timely treatment and prevention of irreversible injury in the ischemic area of the brain.