MR灌注加权成像与CT灌注成像评估烟雾病患者脑血流动力学的比较研究

Comparison of MR Perfusion Weighted Imaging and CT Perfusion Imaging in Assessing Hemodynamics of Patients with Moyamoya Disease

目的探讨磁共振灌注加权成像(MR perfusion weighted imaging,PWI-MRI)与CT灌注成像(CT perfusion imaging,CTP)评估烟雾病患者脑血流动力学结果的相关性。方法选取24例经数字减影血管造影术(digital subtraction angiography,DSA)或时间飞跃法-磁共振血管成像(time of flight-MR angiography,TOFMRA)证实、并行脑血管重建术的烟雾病患者,回顾性分析术前一周内PWI-MRI及CTP的灌注参数图像[灌注参数包括脑血流量(cerebral blood flow,CBF)、脑血容量(cerebral blood volume,CBV)、达峰时间(time to peak,TTP)和平均通过时间(mean transmit time,MTT)],分别得到拟手术侧灌注缺损区与同侧小脑对照区的相对灌注参数(rCBF、rCBV、rMTT、rTTP)。另选取无灌注缺损并排除脑血管疾病的17例患者作为对照组。对烟雾病组和对照组的灌注结果进行比较,并对各组的参数进行Pearson相关分析。结果与对照组相比,烟雾病组患者的PWIMRI、CTP各参数图上均有不同程度的灌注缺损区,烟雾病组rCBF、rCBV下降,rMTT、rTTP延长(P<0.01)。在烟雾病组患者中,PWI-MRI与CTP所得同种灌注参数之间的差异均具有统计学意义(P<0.01),但相关分析显示同种灌注参数之间均具有较强相关性(r值:rCBF为0.791,rCBV为0.832,rMTT为0.748,rTTP为0.812)。结论PWI-MRI与CTP均能得到定量的灌注参数,对烟雾病患者灌注缺损的部位与程度作出评估。

Objective To determine consistencies between MR perfusion weighted imaging （PW-MRI） and CT perfusion imaging （CTP） in assessing hemodynamics of patients with moyamoya disease （MMD）. Methods Images of PWI and CTP scan [including the map of cerebral blood flow （CBF）, cerebral blood volume （CBV）, time to peak （TTP）, and mean transmit time （MTT）] of 24 MMD patients diagnosed by digital subtraction angiography （DSA） or time of flight-MR angiography （TOF-MRA） were obtained in the week before vascular reconstruction operations. Relative perfusion parameters （rCBF, rCBV, rMTT, rTTP） at the operative side within the middle cerebral artery territory and cerebellar hemisphere were compared with those of 17 patients without hypoperfusion and cerebrovascular disease using independent sample t test. Paired t test and Pearson correlation analyses were performed between the results of PWI-MRI and CTP. Results Different parameters were found in the MMD patients compared with the controls （P〈0.05）. The parameter results of PWI-MRI differed from those of CTP, but they were strongly correlated. Conclusion Both PWI-MRI and CTP can detect the area and degree of hypoperfusion of MMD patients.