急性脑血管病诊断中磁共振扩散加权成像与动脉自旋标记的应用价值

Application Value of Magnetic Resonance Diffusion-Weighted Imaging and Arterial Spin Markers in the Diagnosis of Acute Cerebrovascular Disease

目的探讨急性脑血管病诊断中磁共振扩散加权成像(magnetic resonance diffusion-weighted imaging,DWI)与动脉自旋标记(arterial spin labeling,ASL)的应用价值。方法选取云南中医药大学第二附属医院医学影像科2019年7月至2020年8月收治的疑似急性脑血管病患者82例,均给予ASL和DWI。分析同时间段病灶中心与健侧相应部位表观扩散系数(ADC)值、病变信号特征变化、ASL和DWI的灵敏度和特异度。结果82例患者中,患侧6 h内、6~24 h、24~48 h及平均值ADC值均低于健侧,差异有统计学意义(P<0.05);健侧与患侧6 h、6~24 h、24~48 h及平均值ADC值,差异无统计意义(P>0.05);所有患者中CASL-PWI低灌注区比DWI的异常信号区大的患者共有47例,而CASL-PWI低灌注区比DWI的异常信号区小的患者共有32例,2种变化信号相等患者6例;DWI<PWI患者中DWI、PWI病变面积均高于DWI=PWI和DWI>PWI,差异有统计学意义(P<0.05);DWI=PWI患者中DWI、PWI病变面积均大于DWI>PWI,差异有统计学意义(P<0.05);联合检查灵敏度与特异度高于单纯使用磁共振扩散加权成像与动脉自旋标记检查,差异有统计学意义(P<0.05)。结论急性脑血管病诊断中,磁共振扩散加权成像与动脉自旋标记检查均有较好的效果,但是联合使用效果更好。

Objective To explore the value of magnetic resonance diffusion-weighted imaging(DWI)and Arterial Spin labeling(ASL)in the diagnosis of acute cerebrovascular diseases.Methods A total of 82 patients with suspected acute cerebrovascular disease admitted to the Medical Imaging Department of the Second Affiliated Hospital of Yunnan University of Traditional Chinese Medicine from July 2019 to August 2020 were selected and imaging was conducted using ASL and DWI.The apparent diffusion coefficient(ADC)values,changes of lesion signal characteristics,sensitivity and specificity of ASL and DWI were analyzed at different time points.Results In all patients,ADC values within 6 h,6~24 h,24~48 h and average values of the affected side were lower than those of the unaffected side,and the differences were statistically significant(P<0.05).There was no statistical significance in ADC values at 6 h,6~24 h,24~48 h in unaffected and affected sides(P>0.05).There were no statistically significant differences between unaffected side and affected side in 6 h,6~24 h,24~48 h and average ADC values(P>0.05).Among all patients,there were 47 patients whose CASL-PWI hypoperfusion area was larger than DWI abnormal signal area,and 32 patients whose CASL-PWI hypoperfusion area was smaller than DWI abnormal signal area,and 6 patients whose two signal changes were equal.The lesion area of DWI and PWI in patients with DWI<PWI was higher than that of DWI=PWI and DWI>PWI,and the difference was statistically significant(P<0.05).DWI=PWI patients’l esion area of DWI and PWI was larger than that of DWI>PWI,and the difference was statistically significant(P<0.05).The sensitivity and specificity of combined examination were higher than those of DWI and spin marking alone,and the difference was statistically significant(P<0.05).Conclusion In the diagnosis of acute cerebrovascular disease,both diffusion weighted magnetic resonance imaging(DWI)and arterial spin labeling are effective,but it is more valuable if combined.