应用PC MRI技术探讨老年性脑萎缩患者脑组织顺应性及流体动力学变化

Application of PC MRI in the study of brain tissue compliance and hydrodynamic changes in elderly patients with cerebral atrophy

目的运用相位对比磁共振成像技术(PC MRI)探讨老年性脑萎缩患者的脑部流体动力学模式及脑组织顺应性改变情况。方法选取42例老年性脑萎缩患者作为脑萎缩组,29例同时间段接诊的健康人作为对照组。两组均进行PC MRI检查,比较对照组、脑萎缩组双侧颈内动脉(ICA)、颈内静脉(IJV),基底动脉(BA)在心动周期内的收缩期达峰流速(PSV)、舒张期达峰流速(PDV)、平均流量(MF)、血管阻力指数(RI)水平,入颅总血流量、IJV引出血流量,中脑导水管(CA)、侧脑室(LV)的面积(Area)、PSV、PDV、MF水平,ICA、BA的“时相-流速曲线”,不同程度及不同年龄段脑萎缩患者左侧(L)-ICA、右侧(R)-ICA、BA、L-IJV、R-IJV的RI水平。结果脑萎缩组L-ICA、R-ICA、L-IJV、BA的PSV分别为(42.10±12.59)、(39.96±12.90)、(20.48±12.61)、(46.06±11.80)cm/s低于对照组的(49.93±11.41)、(50.97±12.25)、(28.24±12.19)、(55.03±6.78)cm/s;L-ICA、R-ICA、L-IJV、R-IJV、BA的PDV分别为(16.81±7.32)、(13.32±13.35)、(4.60±10.11)、(15.37±9.66)、(14.83±19.03)cm/s低于对照组的(22.95±7.45)、(23.72±8.14)、(13.28±8.42)、(22.47±12.69)、(26.15±5.80)cm/s;R-ICA的MF为(3.13±1.01)ml/s低于对照组的(3.93±0.94)ml/s;L-ICA、R-ICA、L-IJV、R-IJV、BA的RI分别为(2.22±0.99)、(2.23±1.35)、(5.10±7.23)、(2.52±1.20)、(2.17±1.99)高于对照组的(1.37±0.33)、(1.54±0.43)、(2.26±1.75)、(1.64±0.56)、(1.31±0.33),差异均具有统计学意义(P<0.05)。脑萎缩组入颅总血流量(8.59±2.15)ml/s低于对照组的(9.93±1.83)ml/s,差异具有统计学意义(P<0.05);对照组与脑萎缩组IJV引出血流量比较,差异无统计学意义(P>0.05)。脑萎缩组患者L-LV、R-LV的Area分别为(8.20±2.30)、(8.07±2.47)cm^(2)大于对照组的(4.69±1.00)、(4.45±1.53)cm^(2),CA的PSV为(4.40±1.12)cm/s、PDV为(3.67±1.17)cm/s低于对照组的(5.86±2.98)、(4.23±0.77)cm/s,CA、L-LV、R-LV的MF分别为(0.035±0.023)、(0.020±0.019)、(0.020±0.016)cm/s低于对照组的(0.100±0.185)、(0.031±0.027)、(0.033±0.037)cm/s,差异均具有统计学意义(P<0.05)。不同程度脑萎缩患者L-ICA、R-ICA、BA、L-IJV、R-IJV的RI水平比较,差异无统计学意义(P>0.05)。不同年龄段脑萎缩患者L-ICA、R-ICA、BA、L-IJV、R-IJV的RI水平比较,差异无统计学意义(P>0.05)。脑萎缩组ICA、BA“时相-流速曲线”的波峰较对照组圆钝、增宽,CA、LV脑脊液“时相-流速曲线”峰值较对照组下降,对照组与脑萎缩组IJV“时相-流速曲线”相似。结论ICA、BA“时相-流速曲线”可反映脑组织缺血、缺氧的程度,评价脑组织顺应性变化。

Objective To discuss the application of phase-contrast(PC MRI)in the study of brain tissue compliance and hydrodynamic changes in elderly patients with cerebral atrophy.Methods There were 42 elderly patients with cerebral atrophy as cerebral atrophy group,and 29 healthy subjects as control group.PC MRI examinations were performed in both groups to compare peak systolic velocity(PSV),peak diastolic velocity(PDV),mean flow(MF)and vascular resistance index(RI)of bilateral internal carotid artery(ICA),internal jugular vein(IJV),and basilar artery(BA)in the cardiac cycle,total cerebral blood flow,IJV bleeding flow,area of cerebral aqueduct(CA)and lateral ventricle(LV)(Area),PSV,PDV,MF level,ICA and BA"phase-velocity curve"between the control group and cerebral atrophy group.RI levels of left(L)-ICA,right(R)-ICA,BA,L-IJV,R-IJV in patients with different degrees of brain atrophy and patients with brain atrophy at different ages.Results The PSV of L-ICA,R-ICA,L-IJV and BA of cerebral atrophy group were(42.10±12.59),(39.96±12.90),(20.48±12.61)and(46.06±11.80)cm/s,which were lower than(49.93±11.41),(50.97±12.25),(28.24±12.19)and(55.03±6.78)cm/s of the control group;the PDV of L-ICA,R-ICA,L-IJV,R-IJV and BA of cerebral atrophy group were(16.81±7.32),(13.32±13.35),(4.60±10.11),(15.37±9.66)and(14.83±19.03)cm/s,which were lower than(22.95±7.45),(23.72±8.14),(13.28±8.42),(22.47±12.69)and(26.15±5.80)cm/s of the control group;the MF of R-ICA of cerebral atrophy group was(3.13±1.01)ml/s,which was lower than(3.93±0.94)ml/s of the control group;the RI of L-ICA,R-ICA,L-IJV,R-IJV and BA of cerebral atrophy group were(2.22±0.99),(2.23±1.35),(5.10±7.23),(2.52±1.20)and(2.17±1.99),which were higher than(1.37±0.33),(1.54±0.43),(2.26±1.75),(1.64±0.56)and(1.31±0.33)of the control group.All the difference was statistically significant(P<0.05).The total cerebral blood flow(8.59±2.15)ml/s of cerebral atrophy group was lower than(9.93±1.83)ml/s of the control group,and the difference was statistically significant(P<0.05);there was no statistically significant difference in IJV drainage flow between the control group and cerebral atrophy group(P>0.05).The Area of L-LV and R-LV in cerebral atrophy group were(8.20±2.30)and(8.07±2.47)cm^(2),which were greater than(4.69±1.00)and(4.45±1.53)cm^(2) of the control group,PSV and PDV of CA were(4.40±1.12)and(3.67±1.17)cm/s,which were lower than(5.86±2.98)and(4.23±0.77)cm/s of the control group,and MF of CA and L-LV,R-LV were(0.035±0.023),(0.020±0.019)and(0.020±0.016)cm/s,which were lower than(0.100±0.185),(0.031±0.027)and(0.033±0.037)cm/s of the control group.All the difference was statistically significant(P<0.05).There was no statistically significant difference in RI of L-ICA,R-ICA,BA,L-IJV and R-IJV of patients with different degrees of brain atrophy(P>0.05).There was no statistically significant difference in RI of L-ICA,R-ICA,BA,L-IJV and R-IJV of patients with brain atrophy at different ages(P>0.05).The peaks of the ICA and BA"phase-velocity curve"of the brain atrophy group were rounder and wider than those of the control group.The peaks of the CA and LV cerebrospinal fluid"phase-velocity curve"were lower than those of the control group.The IJV"phase-velocity curve"of the control group was similar to that of the brain atrophy group.Conclusion ICA and BA"phase-velocity curve"can reflect the degree of brain tissue ischemia and hypoxia,and evaluate changes in brain tissue compliance.