DSC-PWI和3D-ASL在短暂性脑缺血发作诊断中的应用价值

Diagnostic value of DSC-PWI and 3D-ASL for transient ischemic attack

目的探讨动态磁敏感对比增强灌注成像(DSC-PWI)和三维动脉自旋标记灌注成像(3D-ASL)在短暂性脑缺血发作(TIA)诊断中的应用价值。方法回顾性分析2020年1月至2021年6月晋城合聚心脑血管病医院收治的72例TIA患者的临床资料,所有患者行常规磁共振成像的DSC-PWI、3D-ASL检查,比较TIA患者在DSC-PWI、3D-ASL中的灌注表现,并分析DSC-PWI中达峰时间(TTP)、平均通过时间(MTT)、脑血容量(CBV)、脑血流量(CBF)与3D-ASL中CBF的关系。结果 72例TIA患者中,3D-ASL高灌注6例,正常灌注10例,低灌注56例;DSC-PWI中TTP显示高灌注6例,正常灌注14例,低灌注52例。3D-ASL与DSC-PWI中TTP低灌注结果一致48例,一致率为66.67%。3D-ASL和DSC-PWI中CBF、CBV的灌注结果差异有统计学意义(P<0.05),和MTT、TTP的灌注结果差异未见统计学意义(P>0.05)。3D-ASL和DSC-PWI中TTP的Kappa=0.588。3D-ASL低灌注阳性率为77.78%(56/72),高于DSC-PWI相应值(P<0.05)。结论在短暂性脑缺血发作诊断中,3D-ASL与DSC-PWI的TTP灌注结果的一致性较好,且二者对检测低灌注均具有较高敏感性。

Objective To investigate the diagnostic value of dynamic susceptibility contrast-perfusion weighted imaging(DSC-PWI)and three-dimensional arterial spin labeling(3D-ASL)for transient ischemic attack(TIA).Methods The clinical data of 72 patients with TIA treated in Jincheng Heju Cardiovascular and Cerebrovascular Disease Hospital from January 2020 to June 2021 were retrospectively analyzed.All patients underwent magnetic resonance imaging DSC-PWI and 3D-ASL examinations.The perfusion performances of DSC-PWI and 3D-ASL in TIA were compared.The relationship of time to peak(TTP),mean transit time(MTT),cerebral blood volume(CBV)and cerebral blood flow(CBF)in DSC-PWI with CBF in 3D-ASL was analyzed.Results Among the 72 patients,3D-ASL showed that there were 6 cases with high perfusion,10 cases with normal perfusion and 56 cases with low perfusion.TTP in DSC-PWI showed that there were 6 cases with high perfusion,14 cases with normal perfusion and 52 cases with low perfusion.Both 3D-ASL and TTP in DSC-PWI showed that there were 48 cases with low perfusion,with coincidence rate of 66.67%.The differences between CBF、CBV in DSC-PWI and 3D-ASL were statistically significant(P<0.05),but difference between MTT、TTP in DSC-PWI and 3D-ASL was not statistically significant(P>0.05).The Kappa of 3D-ASL and TTP in DSC-PWI was 0.588.The positive rate of low perfusion by 3D-ASL was 77.78%(56/72),higher than that by DSC-PWI(P<0.05).Conclusions The consistency between 3D-ASL and TTP in DSC-PWI is good in the diagnosis of TIA,which are of high sensitivity in the detection of low perfusion.