3D-ASL與DWI在急性缺血性腦梗死中的對比研究

Comparison study of 3D-ASL and DWI in acute ischemic stroke

目的探討磁共振三維動脈自旋標記成像(3D-ASL)及彌散加權成像(DWI)對急性缺血性腦梗死區域低灌注狀態診斷的可靠性。方法對15例急性腦梗死患者分別行常規MRI、DWI、MRA及3D-ASL序列掃描,觀察3D-ASL與DWI序列病變區最大層面面積的大小及與MRA之間的關係。結果15例患者中的3D-ASL均顯示不同程度灌注異常,與DWI梗死灶一致,ASL-CBF圖上灌注異常區最大面積為(6.52±2.80)cm^(2),DWI梗死區最大面積為(6.52±2.80)cm^(2);ASL-CBF圖上的灌注異常面積大於DWI圖上的梗死面積,且差異有統計學意義(P=0.035)。結論3D-ASL可有效顯示急性梗死的血流灌注改變,結合DWI可初步判斷腦梗死可存活區,有利於及時指導腦梗死的溶栓治療。

Objective To explore the reliability of 3D arterial spin labeling(3D-ASL)and diffusion weighted imaging(DWI)in the diagnosis of hypoperfusion in acute ischemic cerebral infarction.Methods A total of 15 patients with acute cerebral infarction underwent conventional MRI,DWI and 3D-ASL scan;lesion area and its cerebral blood flow(CBF)value were measured on DWI and 3D-ASL maps,which were compared to MRA.Results All 15 patients with acute cerebral infarction showed different degrees of perfusion abnormality on 3D-ASL maps,which was consistent with the infarct observed on DWI.The largest area of abnormal perfusion on 3D-ASL-CBF was(9.17±3.15)cm^(2),whereas the largest area of infarction on DWI maps was(6.52±2.80)cm^(2),which was statistically different(P=0.035).Conclusion 3D-ASL enables us to effectively diagnose blood perfusion changes in patients with acute cerebral infarction.Combined with DWI,the survival of affected lesion area in cerebral infarction can be preliminarily determined,providing guidance in optimal timing of thrombolytic therapy.