3D-ASL评估慢性期皮层下脑梗死脑血流量改变

3D-ASL assessment of cerebral blood flow changes in chronic stroke patients

目的采用3D动脉自旋标记(arterial spin labeling,ASL)灌注成像评估运动功能恢复较好的慢性期皮层下脑梗死患者的静息态脑血流量(cerebral blood flow,CBF),并分析其与认知功能中执行能力的关系。材料与方法采用GE Discovery MR 750扫描仪对29例慢性期脑梗死患者及30例健康志愿者行3D动脉自旋标记灌注成像。以SPM8中的GLM(一般线性模型)为参考,把教育年限、年龄、性别当作协变量,把“全脑灰质模板”当作mask,实施独立样本t检验,明确对照组、病例组脑血流量不同的脑区,并对其同执行能力间的联系展开讨论。结果相较于对照组,患者健侧缘上回(supramarginal gyrus,SMG)与额上回(superior frontal gyrus,SFG)脑血流量皆显著增加(P<0.05)。上述2个脑区的CBF值皆于连线测试B的反应时间呈负向相关。结论运动功能有效恢复的慢性期皮层下脑梗死患者远隔病灶的皮层区CBF仍存在异常,同时此部位CBF的改变同认知功能中的执行能力存在相关性。

Objective:To evaluate resting-state cerebral blood flow(CBF)and the relationship between cerebral blood flow and cognitive function in well-recovered patients 6 months after subcortical ischemic stroke used 3D arterial spin labeling(3D-ASL)imaging.Materials and Methods:A total of 29 well-recovered patients 6 months after subcortical ischemic stroke patients and 30 healthy subjects were investigated to undergo 3D arterial spin labeling(3D-ASL)using GE Discovery MR 7503.0 Tesla MR scanner and behavioral tasks.The CBF maps were processing via SPM8 in Matlab.The GLM was applied to quantitatively compare group differences in CBF throughout the whole brain with age,gender and the years of education as covariates of no interest with SPM8.Moreover,we performed partial correlation analysis to investigate the association between the clinical behavior scores and the statistics results of CBF with SPSS 17.0.Results:The voxel-wise analysis showed that the well-recovered stroke patients exhibited increased CBF in contralesional superior frontal gyrus(SFG)and supramarginal gyrus(SMG)compared with normal controls(P<0.05,cluster size>1054 voxels).Moreover,the increased CBFs of the contralesional SFG(r=−0.41,P=0.037),and supramarginal gyrus(SMG)(r=−0.42,P=0.036)were all significant negative correlation with TMT-B.Conclusions:We identified cerebral blood flow altered in the contralesional hemisphere in the subcortical stroke patients with well-recovery global motor function.Moreover,increased CBF were correlated with cognitive functional may represent a compensatory reorganization for the cognitive functional decline of subcortical stroke patients.