1.5T磁共振ASL、DWI及MRS评价急性缺血性脑梗死缺血半暗带应用价值

1.5T Magnetic Resonance ASL, DWI and MRS Evaluation of Ischemic Penumbra in Acute Ischemic Stroke

目的评价磁共振功能成像对急性脑梗塞缺血半暗带的诊断价值。方法采用新光纤GE1.5 TMR扫描仪的常规序列及功能成像对临床未进行溶栓治疗的早期非腔隙性脑梗塞患者缺血半暗带进行数据分析。结果 DWI能完全检出所有急性脑梗死病例,ASL能检出所有大面积急性脑梗死病例,对小面积急性缺血性脑梗死的检出率约为66%。Lac升高NAA变化不明显组和ASL与DWI异常不匹区组为"IP区";NAA明显下降甚至消失组和ASL与DWI异常的匹配区组为"中心梗死区"。结论 DWI、3D-ASL及1H-MRS扫描联合应用,能准确判断缺血半暗带的存在及界定范围。Lac和NAA的变化是观察脑缺血后脑细胞代谢变化的无创性检查较有价值的技术。

Objective Diagnostic value of functional magnetic resonance imaging in ischemic penumbra of acute cerebral infarction. Methods Analysis of ischemic penumbra in patients with early non lacunar cerebral infarction treated with conventional sequence and functional imaging using a new fiber GE1.5TMR scanner. Results All cases of acute cerebral infarction were detected by DWI,ASL can detect all cases of acute cerebral infarction,The detection rate of acute ischemic cerebral infarction was about 66%.Lac elevation of NAA change was not obvious in group DWI and ASL abnormal group was 'IP area'. NAA decreased significantly or disappeared, and the matched group of ASL and DWI abnormalities was 'central infarction zone'. Conclusion Combined application of DWI, 3D-ASL and 1H-MRS scan,Can accurately determine the presence and extent of ischemic penumbra.The change of Lac and NAA is a valuable technique to observe the metabolic changes of brain cells after cerebral ischemia.