磁共振弥散张量成像及动脉自旋标记成像在缺血性脑梗死诊断及分期中的应用价值

Application value of magnetic resonance diffusion tensor imaging and arterial spin labeling in the diagnosis and staging of cerebral ischemic infarction

目的研究磁共振弥散张量成像(DTI)、动脉自旋标记(ASL)成像在缺血性脑梗死诊断及分期中的应用价值。方法选择2019年4月至2019年10月中国人民解放军陆军第八十三集团军医院收治的50例缺血性脑梗死患者为研究对象,其中超急性期5例,急性期17例,亚急性期13例,慢性期15例,患者均行DTI和ASL检查,比较梗死区和健侧区各向异性分数(FA)、表观弥散系数(ADC)、脑血流量(CBF)及相对脑血流量(rCBF)值。结果患者梗死区FA、ADC和CBF均小于健侧区(P<0.05)。左侧额叶急性期脑梗死表现为稍长T1稍长T2信号,磁共振弥散加权成像呈高信号;梗死区较健侧区表现为蓝色。不同临床分期患者的FA、ADC和rCBF值比较差异均有统计学意义(P<0.05)。FA、rCBF在超急性期、急性期、亚急性期和慢性期呈现逐渐下降趋势,而ADC在超急性期、急性期、亚急性期和慢性期呈逐渐升高趋势。Pearson相关性分析结果显示,ADC与FA、rCBF呈负相关(r=-0.617、-0.327,P<0.05),FA与rCBF呈正相关(r=0.339,P<0.05)。结论DTI和ASL有助于缺血性脑梗死诊断及分期,为临床治疗方案的选择提供依据。

Objective To explore the application value of magnetic resonance diffusion tensor imaging(DTI)and arterial spin labeling(ASL)imaging in the diagnosis and staging of cerebral ischemic infarction.Methods A total of 50 patients with cerebral ischemic infarction admitted to the 83 rd Group Army Hospital of Chinese People′s Liberation Army from April 2019 to October 2019 were selected as the study objects;of which 5 patients were in the hyperacute stage,17 patients were in the acute stage,13 patients were in the subacute stage,and 15 patients were in the chronic stage.All patients underwent DTI and ASL examinations,and the values of fractional anisotropy(FA),apparent diffusion coefficient(ADC),cerebral blood flow(CBF)and relative cerebral blood flow(rCBF)in infarct and healthy side were compared.Results The FA,ADC and CBF value in infarcted area were lower than those in healthy area(P<0.05).The left frontal lobe showed slightly longer T1 and slightly longer T2 signal,diffusion weighted imaging showed high signal,and the infarct area were blue.There was statistic difference in the FA,ADC and rCBF value among different clinical stages patients(P<0.05).FA and rCBF values showed a gradual downward trend,and the ADC value showed a gradual upward trend in hyperacute stage,acute stage,subacute stage,chronic stage patients.Pearson correlation analysis showed that ADC was negatively correlated with FA and rCBF(r=-0.617,-0.327;P<0.05);FA was positively correlated with rCBF(r=0.339,P<0.05).Conclusion DTI and ASL are helpful for the diagnosis and staging of ischemic cerebral infarction,and can provide basis for the choice of clinical treatment plans.