3D-ASL联合MRA在短暂性脑缺血发作中的应用价值研究

Application Value of Three-Dimensional Arterial Spin Labeling Technique Combined with Magnetic Resonance Angiography in Transient Ischemic Attack

目的探讨三维动脉自旋标记技术(Three-dimensional Arterial Spin Labeling,3D-ASL)联合磁共振血管成像(Magnetic Resonance Angiography,MRA)在短暂性脑缺血发作(Transient Ischemic Attack,TIA)诊断中的临床应用价值。方法选取本院就诊的TIA患者36例,入选者均行常规MR检查、DWI、MRA及3D-ASL检查。由2名医生重建图像并定量测量脑血流量(Cerebral Blood Flow,CBF)。结果TIA患者3D-ASL示患侧灌注减低者明显多于健侧,差异有统计学意义(P<0.05)。TIA患者MRA示患侧平均CBF值(25.0±9.6)mL/(100g·min)低于健侧(44.0±13.5)mL/(100g·min),差异有统计学意义(P<0.05)。3D-ASL显示患侧灌注减低的患者27例(75.0%);MRA显示血管狭窄的患者16例(44.0%);两者联合应用显示异常的患者29例(80.0%)。3D-ASL和MRA联合检查的诊断正确率高于单独使用3D-ASL或MRA检查。结论3D-ASL技术可以发现TIA患者常规MR检查中无法发现的早期血流灌注异常,与MRA联合应用,可提高对TIA的诊断正确率。

Objective To investigate the clinical value of three-dimensional arterial spin labeling(3D-ASL)combined with magnetic resonance angiography(MRA)in the diagnosis of transient ischemic attack(TIA).Methods Thirty-six patients with TIA who were admitted to our hospital were enrolled.All patients underwent routine MR examination,DWI,MRA and 3D-ASL examination.Two doctors reconstructed images and quantitatively analyzed cerebral blood flow(CBF).Results The 3D-ASL of TIA patients showed that the patients with hypoperfusion on the affected side were significantly more than those on the healthy side,and the difference was statistically significant(P<0.05).The mean CBF of the affected side of TIA patients[(25.0±9.6)mL/(100g·min)]was statistically lower(P<0.05)than that of the healthy side[(44.0±13.5)mL/(100g·min)].3D-ASL showed that 27 patients(75.0%)with reduced perfusion of the affected side.MRA showed that there were 16 patients(44.0%)with vascular stenosis.The combined application of 3D-ASL and MRA showed that there were 29 cases(80.0%)with abnormality.The diagnostic accuracy of the joint examination was higher than the 3D-ASL examination or the MRA examination.Conclusion 3D-ASL technology can detect early blood perfusion abnormalities that cannot be found in routine MR examination in TIA patients.Combined with MRA,it can improve the diagnostic accuracy of TIA.