3D-ASL在缺血性脑梗死诊断中的应用探讨

The Application of 3D-ASL in the Diagnosis of Ischemic Cerebral Infarction

目的探讨3.0T磁共振三维动脉自旋标记成像结合常规检查序列扫描对缺血性脑梗死患者的诊断价值。方法选取我院就诊的缺血性脑梗死的患者19例,患者均先行头颅常规CT及磁共振常规头颅扫描,然后进行3D-ASL检查,以及异常灌注与DWI梗塞范围的差异,定性分析相对脑血流量(r CBF),同时观察病变侧周围的大血管情况。结果 19例患者中,15例ASL呈现血流低灌注,相对平均脑血流量(r CBF)低于健侧,其中12例ASL灌注彩图获得的低灌注范围较DWI范围明显增大;3例异常低灌注范围与DWI梗塞范围一致;4例在MRA表现为一侧大脑中动脉的闭塞或狭窄。结论 3D-ASL结合MRA及DWI,可定性、定量地分析缺血性脑梗死组织的脑血流量、血流灌注程度、梗死区周围的脑血管情况,评估疗效及判断预后。

Objective To investigate the diagnostic value of 3.0 T magnetic resonance three-dimensional spin-labeled imaging combined with routine examination of sequence scan in patients with ischemic cerebral infarction. Methods Totally 19 patients with ischemic stroke admitted to our hospital were enrolled in this study. All patients underwent conventional craniocerebral CT and conventional magnetic resonance scintigraphy. 3 D-ASL examination and the difference of infarct size between abnormal perfusion and DWI were performed. Blood flow(r CBF), while observing the lesion side of the large blood vessels. Results In the 19 patients, 15 cases of ASL showed low blood perfusion and relative mean cerebral blood flow(r CBF) was lower than that of contralateral side. The low perfusion range of 12 ASL perfusion color maps was significantly larger than that of DWI, and 3 cases were abnormal Low perfusion range and DWI infarction range; 4 cases of MRA showed side of the middle cerebral artery occlusion or stenosis. Conclusion 3 D-ASL combined with MRA and DWI, qualitative and quantitative analysis of cerebral blood in ischemic cerebral infarction Flow, degree of perfusion, cerebrovascular disease around the infarct area, assessment of efficacy and prognosis.