SWAN联合3DASL在单侧大脑中动脉M1段慢性闭塞后临床预后评估中的应用价值

Application value of SWAN combined with 3D ASL in clinical prognosis evaluation of M1 segment chronic occlusion of unilateral middle cerebral artery

目的探讨T2*加权血管成像(SWAN)联合三维动脉自旋标记(3D ASL)在单侧大脑中动脉(MCA)M1段慢性闭塞后临床预后评估方面的临床应用价值。方法回顾性分析2018年1月至2021年2月于南京中医药大学连云港附属医院行磁共振SWAN及3D ASL序列检查的单侧MCA M1段慢性闭塞患者42例,其中男24例,女18例,年龄(53.3±8.8)岁。分析闭塞侧MCA供血区突出血管征(PVS)、脑血流量(CBF)值与患者3个月内缺血性脑血管病发生率之间的相关性。结果PVS阳性组MCA M1段供血区(额叶、顶叶、颞叶及侧脑室旁白质区)CBF值分别为(33.55±6.5)ml(/100 g·min)、(32.67±7.16)ml(/100 g·min)、(33.80±6.86)ml(/100 g·min)、(29.83±5.92)ml(/100 g·min),均低于PVS阴性组(42.28±6.79)ml(/100 g·min)、(41.90±6.78)ml(/100 g·min)、(42.49±6.57)ml(/100 g·min)、(34.31±7.10)ml(/100 g·min),差异均有统计学意义(均P<0.05)。PVS阳性组3个月内缺血性脑血管病发生率为47.06%(8/17),明显高于PVS阴性组20.00%(5/25),差异有统计学意义(P<0.05)。结论单侧MCA M1段慢性闭塞后,SWAN及3D ASL能够客观反映脑灌注状态,在评估患者近期临床预后方面具有重要应用价值。

Objective To investigate the clinical application value of T2 star weighted angiography(SWAN)combined with three-dimensional arterial spin labeling(3D ASL)in evaluating the clinical prognosis after unilateral middle cerebral artery(MCA)chronic occlusion at M1 segment.Methods A retrospective analysis was performed on 42 patients with M1 segment chronic occlusion of unilateral MCA who received MR SWAN and 3D ASL sequence examination in Nanjing University of Chinese Medicine Affiliated Lianyungang Hospital from January 2018 to February 2021,including 24 males and 18 females,with an age of(53.3±8.8)years old.The correlations between prominent vessel sign(PVS)and cerebral blood flow(CBF)in the occlusive MCA blood supply area and the incidence of ischemic cerebrovascular diseases in the patients within 3 months were analyzed.Results The CBF values in the occlusive MCA M1 segment blood supply area(frontal lobe,parietal lobe,temporal lobe,and paraventricular white matter region)in the PVS positive group were(33.55±6.5)ml/(100 g·min),(32.67±7.16)ml/(100 g·min),(33.80±6.86)ml/(100 g·min),and(29.83±5.92)ml/(100 g·min),which were lower than those in the PVS negative group[(42.28±6.79)ml/(100 g·min),(41.90±6.78)ml/(100 g·min),(42.49±6.57)ml/(100 g·min),and(34.31±7.10)ml/(100 g·min)],with statistically significant differences(all P<0.05).The incidence of ischemic cerebrovascular diseases within 3 months in the PVS positive group was 47.06%(8/17),which was higher than that in the PVS negative group[20.00%(5/25)](P<0.05).Conclusion SWAN and 3D ASL can objectively reflect the status of cerebral perfusion after unilateral MCA M1 segment chronic occlusion,and have important application values in evaluating the short-term clinical prognosis of patients.