定量脑电图联合ASL灌注成像在单侧大脑中动脉狭窄患者中的评估

Evaluation of quantitative electroencephalogram combined with ASL perfusion imaging in patients with unilateral middle cerebral artery stenosis

目的 分析定量脑电图(quantitative electroencephalogram, qEEG)联合磁共振动脉自旋标记(arterial spin labeling, ASL)灌注成像对单侧大脑中动脉(middle cerebral artery stenosis, MCA)狭窄的评估价值。方法 纳入单侧MCA狭窄患者82例作为研究对象,所有患者均行qEEG、ASL灌注成像及CT脑血管造影(CT angiography, CTA)检查,根据CTA检查结果将患者分为轻度狭窄组、中度狭窄组和重度狭窄组,比较3组患者qEEG与ASL灌注成像参数[慢波化指数(delta and theta/alpha+beta ratio, DTABR)、脑电时间对称指数(temporal brain symmetry index, tBSI)、脑电图空间对称指数(spatial brain symmetry index, sBSI)、脑血流量值(cerebral blood flow, CBF)],分析qEEG联合ASL灌注成像对单侧MCA狭窄的评估价值。结果 82例单侧MCA狭窄患者经CTA检查显示,轻度狭窄28例、中度狭窄32例、重度狭窄22例。中度狭窄组和重度狭窄组sBSI、tBSI值高于轻度狭窄组,重度狭窄组sBSI、tBSI值高于中度狭窄组(P<0.05);中度狭窄组和重度狭窄组患侧CBF值、患侧与健侧CBF比值、MoCA及MMSE评分低于轻度狭窄组,重度狭窄组低于中度狭窄组(P<0.05);绘制受试者工作特征(receiver operating cure, ROC)曲线,结果显示sBSI、tBSI、患侧CBF、患侧与健侧CBF比值单独及联合评估轻中度及中重度MCA狭窄的AUC均>0.7,具有中等评估价值,联合评估价值最佳。结论 qEEG联合ASL灌注成像对单侧MCA狭窄具有较高的评估价值,可准确反映MCA狭窄程度。

Objective To analyze the value of quantitative electroencephalogram(qEEG)combined with magnetic resonance arterial spin labeling(ASL)perfusion imaging in evaluating unilateral middle cerebral artery(MCA)stenosis.Methods The patients with unilateral MCA stenosis were prospectively included as the research subjects.All patients underwent qEEG,ASL perfusion imaging and CT angiography(CTA).According to the results of CTA,patients were divided into mild stenosis group,moderate stenosis group and severe stenosis group.The qEEG and ASL perfusion imaging parameters[delta and theta/alpha+beta ratio(DTABR),temporal brain symmetry index(tBSI),spatial brain symmetry index(sBSI),cerebral blood flow(CBF)]of the three groups were compared,and the evaluation value of qEEG combined with ASL perfusion imaging for unilateral MCA stenosis was analyzed.Results Among 82 patients with unilateral MCA stenosis,CTA examination showed 28 cases of mild stenosis,32 cases of moderate stenosis,and 22 cases of severe stenosis.The sBSI and tBSI values in the moderate and severe stenosis groups were higher than those in the mild stenosis group,while the sBSI and tBSI values in the severe stenosis group were higher than those in the moderate stenosis group(P<0.05).The CBF value,CBF ratio on the affected side and the healthy side,Montreal Cognitive Assessment(MoCA)and Mini-Mental State Examination(MMSE)scores of the moderate and severe stenosis groups were lower than those of the mild stenosis group,while the scores of the severe stenosis group were lower than those of the moderate stenosis group(P<0.05).Receiver operating characteristic(ROC)curve was drawn,and the results showed the area under the ROC curve(AUC)of sBSI,tBSI,CBF on the affected side,and CBF ratio on the affected side and the healthy side alone and in combination in evaluating mild to moderate and moderate to severe MCA stenosis was all greater than 0.7,indicating moderate evaluation value,with the best evaluation value by combination.Conclusion qEEG combined with ASL perfusion imaging has high evaluation value for unilateral MCA stenosis,and can accurately reflect the degree of MCA stenosis.