三维伪连续式动脉自旋标记技术对高血压脑白质疏松应用价值

The application value of 3D-pcASL in the osteoporosis of hypertensive white matter

目的探讨3.0T高分辨磁共振的三维的伪连续式动脉自旋标记技术(3D-pcASL)的高血压脑白质疏松(LA)的局限性脑血流(rCBF)与LA不同分级之间关系及临床应用价值.方法 90例高血压患者,其中LA的0~3级的的患者分别20、24、23、23例行常规头颅磁共振成像(MRI)、3D-pcASL检查,测出LA各级双侧半卵圆中心、侧脑室前角、旁、后角处及额叶、顶叶、颞叶和枕叶皮质的rCBF值,分析rCBF值与各级LA之间关系及临床意义,并采取经Kruskal-Wallis H和Spearman检验.结果双侧半卵圆中心、侧脑室前角、旁、后角处rCBF值的1级LA的卵圆中心、侧脑室前角、旁、后角rCBF值均高于0、2、3级LA,0级LA高于2、3级LA,3级低于2级,经Kruskal-Wallis H检验,各等级间比较差异有统计学意义(P<0.01).CBF与各级LA之间有一定相关性(r=-0.539、r=-0.250、r=-0.444、r=-0.575).经Spearman等级相关系数比较,额叶皮质与LA等级间呈负相关(r=-0.253,P=0.024).顶叶、颞叶、枕叶皮质与LA等级间相关系数P>0.05,差异无统计学意义.结论 3D-pcASL技术不仅可以对全脑灌注还可以对rCBF进行定量分析和重复性强,对高血压LA的发病机制和发展过程,有助于临床对LA各级治疗前后的rCBF变化改变,早期药物治疗方案提供依据,从而从改善病情,降低、减轻和延缓LA发展,甚至恢复可能,达到"治未病"防治老年痴呆和脑卒中发生具有重大临床意义.

Objective To investigate the effects of 3.0 T of high-resolution mri three-dimensional pseudo continuous arterial spin labeling technique(three dimensional pseudo continuous arterial spin labeling, 3 D-pcASL) hypertension cerebral white matter of osteoporosis(leukoaraiosis, LA) the limitation of the cerebral blood flow(relative cere-bral blood flow, rCBF) and LA relations between different classification and clinical application value. Methods Ninety cases of patients with high blood pressure, including LA of level 0 to 3 patients respectively 20, 24, 23, 23 routine head MRI, 3 D-pcASL, measure LA bilateral half egg circle center at all levels, the anterior horn of lateral ventricle, side and back Angle and frontal, parietal and occipital lobe, temporal lobe cortex of rCBF value, analyzing the relation between rCBF value with all levels of LA and clinical significance, and take the Kruskal Wallis H and Spearman inspection. Results The rCBF values of the 1-grade LA of the rCBF values of the bilateral semi-oval center, lateral ventricle, lateral ventricle and posterior horn were all higher than the 0, 2, 3 LA, 0-grade LA were higher than the 2, 3 LA, and the 3-grade LA were lower than the 2-grade. Kruskal-Wallis H test showed that the differences between the levels were statistically significant(P<0.01). There is a certain correlation between CBF and all levels of LA(r=-0.539, r=-0.250, r=-0.444, r=-0.575). After the Spearman rank correlation coefficient comparison, r=-0.253 and P=0.024 were negatively correlated between the frontal cortex and LA rank, showing statistical significance. Cor-relation coefficients between parietal lobe, temporal lobe, occipital cortex and LA grade P>0.05, no statistical significance. Conclusion 3 D-pcASL technology not only can the whole cerebral perfusion of rCBF can also strong quantitative analysis and repeatability, the pathogenesis and development of hypertension LA process, help clinical treatment at all levels of LA rCBF changes before and after the change, provide basis for early drug treatment, to improve the condition, reduce, reduce and delay the development of LA, may restore, achieve "cure not ill" prevention and treatment of senile dementia and cerebral stroke have great clinical significance.