动脉自旋标记在急性脑梗死中的应用

Application of Arterial Spin Labeling in Acute Cerebral Infarction

目的探讨动脉自旋标记(ASL)在急性脑梗死中的应用价值。方法选取2016年8月~2018年2月我院收治的脑梗死患者29例,所有患者均行扩散加权(DWI)、ASL及脑血管成像(MRA)扫描。分析急性脑梗死患者的基线ASL数据,比较治疗前后存在缺血半暗带(IP)患者DWI高信号区与周边低灌注区CBF患侧、CBF对侧、rCBF以及ASL-CBF。结果29例急性脑梗死患者中,22例患者存在IP,7例患者不存在IP。22例IP患者中,DWI高信号区CBF患侧血流值低于CBF对侧,周边低灌注区3、6、9、12点钟ROICBF患侧血流值低于CBF对侧,且高于DWI高信号区,差异有统计学意义(P<0.05)。DWI高信号区与周边低灌注区对侧血流值比较,差异无统计学意义(P>0.05)。DWI高信号区治疗前后ASL-CBF比较,差异无统计学意义(P>0.05)。治疗后,周边低灌注区3、6、9、12点钟ROIASL-CBF均高于治疗前,差异有统计学意义(P<0.05)。结论ASL能在一定程度上反映脑低灌注水平,与DWI配合可辅助诊断IP,可提示预后。

Objective To investigate the value of arterial spin labeling (ASL) in acute cerebral infarction. Methods 29 patients with cerebral infarction admitted to our hospital from August 2016 to February 2018 were enrolled. All patients underwent diffusion-weighted (DWI), ASL and cerebrovascular imaging (MRA) scans. Baseline ASL data were analyzed in patients with acute cerebral infarction, Before and after treatment, patients with ischemic penumbra (IP) had DWI high signal area and peripheral low perfusion area CBF side, CBF contralateral side, rCBF and ASL-CBF. Results Of the 29 patients with acute cerebral infarction, 22 had IP and 7 had no IP. In 22 patients with IP, the blood flow value of the CBF side of the DWI high signal area was lower than that of the CBF side, and the blood flow value of the ROI CBF side was lower than the CBF side at 3, 6, 9, and 12 o'clock in the peripheral low perfusion area. In the DWI high signal area, the difference was statistically significant (P<0.05). There was no significant difference in the blood flow value between the DWI high signal area and the surrounding low perfusion area (P>0.05). There was no significant difference in ASL-CBF between DWI and high signal area before and after treatment (P>0.05). After treatment, the ROI ASL-CBF at 3, 6, 9 and 12 o'clock in the peripheral hypoperfusion area was higher than that before treatment,the difference was statistically significant (P<0.05). Conclusion ASL can reflect the level of cerebral hypoperfusion to a certain extent. Cooperating with DWI can assist in the diagnosis of IP, which may indicate prognosis.