多反转时间动脉自旋标记成像定量分析高血压脑血流动力学改变

Quantitative analysis of cerebral hemodynamics change in hypertensive patients with multiple inversion time-pulsed arterial spin labeling imaging

目的观察多反转时间动脉自旋标记(mTI-ASL)技术定量分析不同程度高血压患者脑血流动力学变化的价值。方法采集55例高血压患者(高血压组)和20名健康志愿者(对照组)的颅脑常规MRI及mTI-ASL图像。将高血压患者分为高血压1级(n=20)、高血压2级(n=20)及高血压3级(n=15)共3个亚组,分析mTI-ASL图像中各亚组及对照组灰质(额叶、颞叶、枕叶)、脑白质(半卵圆中心、侧脑室前角及后角旁白质、胼胝体膝部和压部)、基底核、丘脑的相对脑血流量(rCBF)及动脉通过时间(ATT),比较rCBF及ATT值差异。结果高血压1级亚组除脑灰质外各脑区rCBF、ATT值与对照组差异均有统计学意义(P均<0.05);高血压2级亚组与高血压1级亚组间半卵圆中心及胼胝体rCBF和半卵圆中心ATT值差异均无统计学意义(P均>0.05),其余各脑区rCBF、ATT值差异均有统计学意义(P均<0.05);除侧脑室前、后角旁白质外,高血压3级亚组与高血压2级亚组间各脑区rCBF、ATT值差异均有统计学意义(P均<0.05);其余各组间不同脑区rCBF值及ATT值差异均有统计学意义(P均<0.05)。结论mTI-ASL成像可定量分析高血压患者脑血流动力学变化,监测高血压病情进展。

Objective To explore the value of multiple inversion time-pulsed arterial spin labeling(mTI-ASL)technique in quantitative analysis of change in cerebral hemodynamics changes in patients with different degrees of hypertension.Methods Brain conventional MRI and mTI-ASL imaging of 55 hypertensive patients(hypertension group)and 20 age-matched healthy volunteers(control group)were collected.Hypertensive patients were divided into 3 subgroups:grade 1 subgroup(n=20),grade 2 subgroup(n=20)and grade 3 subgroup(n=15).The relative cerebral blood flow(rCBF)and arterial transit time(ATT)of gray matter(frontal lobe,temporal lobe and occipital lobe),white matter(bilateral centrum semiovale,anterior and posterior horns of paraventricular white matter,genu and spleniu of corpus callosum),basal ganglia and thalamus were obtained from mTI-ASL images,and the differences of rCBF and ATT values among the groups were compared.Results Except for gray matter,the rCBF and ATT values of each brain region of hypertension grade 1 subgroup were lower than that of control group(all P<0.05).There was no significant difference in rCBF values of bilateral centrum semiovale and corpus callosum and ATT values of bilateral centrum semiovale between hypertension grade 1 subgroup and hypertension grade 2 subgroup(all P>0.05),but there were statistical differences in rCBF and ATT values of other brain regions(all P<0.05).Except for white matter of anterior and posterior horn of lateral ventricle,the rCBF and ATT values of other brain regions between hypertension grade 3 subgroup and hypertension grade 2 subgroup were statistical significant(all P<0.05).There were statistical differences in rCBF and ATT values in different brain regions among the other groups(all P<0.05).Conclusion mTI-ASL imaging can quantitatively analyze the changes of cerebral hemodynamics in hypertensive patients,monitoring the progression of hypertension.