3D-ASL在TIA预后的前瞻性评价中的价值

The Value of 3D-ASL in the prognosis of prospective evaluation of TIA

目的探讨磁共振三维动脉自旋标记技术(3D-ASL)在短暂性脑缺血发作(transient ischemic attack, TIA)预后中的临床价值。方法对172例TIA患者进行3D-ASL和MRA检查,除外颈脑动脉中度及以上狭窄的患者34例,将剩余138例TIA患者根据腔隙性脑梗死情况分为三组,分析三组的血流变化趋势、发病一周内的脑梗死情况及两者关系。结果 TIA的血流变化可分为三种趋势,分别为Ⅰ型缺血型、Ⅱ型正常型、Ⅲ型过度灌注型。Ⅰ型在一周内发生脑梗死的机率最多,为22%(7/32),Ⅱ型次之,为7%(4/61),Ⅲ型最少,为4%(2/45)。Ⅰ型和Ⅱ型、Ⅲ型间均有统计学意义,(P=0.062、P=0.043),Ⅱ型和Ⅱ型间无统计学意义(P=0.708)。结论 TIA发作期患者血流变化存在三种趋势。利用3D-ASL结合血流变化趋势,能对TIA患者预后做出较准确判断,为患者制定个性化的治疗手段提供依据。

Objective To investigate the value of magnetic resonance three-dimensional arterial spin labeling(3 D-ASL) in the prognosis of prospective evaluation of transient ischemic attack(TIA). Methods 3 D-ASL and MRA were performed in 172 patients with TIA, 34 patients with moderate or above carotid artery stenosis were excluded. The remaining 138 patients with TIA were divided into three groups according to lacunar infarction. Results The changes of blood flow in TIA can be divided into three trends: type Ⅰ, Ischemia;type Ⅱ, normal;type Ⅲ, Overperfusion. Type Ⅰ had the most cerebral infarction in one week, acounting of 22%(7/32). Type Ⅱ was 7%(4/61), type III was 4%(2/45), and there was statistical significance between type Ⅰ and type Ⅱ, type Ⅲ. There was no significant difference between type Ⅱ and type Ⅱ. Conclusion There are three trends in blood flow changes in the patients with TIA. Using 3 D-ASL combined with the trend of blood flow changes can accurately judge the prognosis in patients with TIA, which provide basis for patients to develop personalized treatment methods.