颈动脉系统短暂性脑缺血发作患者FLAIR序列高信号血管征与CT灌注成像的对照研究

Fluid-Attenuated Inversion Recovery Vascular Hyperintensities:A Comparative Study with CT Perfusion Imaging in Transient Ischemic Attack Patients of Carotid Artery System

目的探讨颈动脉系统短暂性脑缺血发作(TIA)患者出现液体衰减反转恢复(FLAIR)序列高信号血管征(FVH)的血流动力学因素。方法搜集2011年6月至2017年4月本院神经外科30例TIA患者,所有病例均证实存在颈动脉系统动脉狭窄,并行常规头颅MR检查及CT灌注成像(CTP)检查。评价患者的动脉狭窄程度、FVH评分、低灌注区域及相关参数,包括平均通过时间(MTT)、脑血流量(CBF)及脑血容量(CBV)。结果低灌注区域、MTT及CBF值在FVH阴性组与阳性组间存在明显统计学差异。FVH评分与各参数间的Spearman秩相关分析显示低灌注区域及MTT与FVH评分存在明显正相关(r=0.755,0.674,P<0.01),与CBF呈中等程度负相关(r=-0.525,P<0.01),而与动脉的狭窄程度无明显相关性(r=0.253,P>0.05)。结论 FVH的出现及分布范围与CTP所显示的低灌注区域及其相应的MTT、CBF值密切相关,由此推测FVH可作为反映TIA患者脑组织灌注不足的一种重要且便捷的影像学表现。

Objective To investigate the hemodynamic factors of hyperintense vessel sign on FLAIR(FHV)in transient ischemic attack(TIA)patients of carotid artery system by using CT perfusion imaging.Methods Consecutive inpatients(n=30)diagnosed with TIAs of the carotid system in a 6-year period(2011-2017)were enrolled in our study.Each had undergone magnetic resonance imaging(MRI)and followed by CT perfusion imaging studies.We investigated the degree of arterial stenosis,FVH score,hypoperfusion area and related parameters,including mean transit time(MTT),cerebral blood flow(CBF)and cerebral blood volume(CBV).Results The hypoperfusion regions,MTT and CBF values were significantly different between the FVH negative group and the positive group.Spearman correlation analysis showed significant positive correlations between hypoperfusion areas,MTT and FVH scores(r=0.755,0.674,respectively,P<0.01);Moderate negative correlation was found between CBF and FVH scores(r=-0.525,P<0.01),whereas the degree of artery stenosis revealed no significant correlation with FVH scores(r=0.253,P>0.05).Conclusion Hyperintense vessels on FLAIR were closely associated with hypoperfusion regions,MTT and CBF values,which indicated that the presence of FVH could be an important and convenient imaging marker of hemodynamic impairment in patients with TIA.