目的探讨3.0T磁共振弥散加权成像(DWI)结合液体衰减翻转恢复(FLAIR)序列、三维动脉自旋标记成像(3D ASL)双不匹配技术对不明发病时间急性脑梗死(ACI)患者的应用价值。方法选取我院进行3.0T磁共振DWI、FLAIR、3D ASL、磁共振血管成像(MRA...目的探讨3.0T磁共振弥散加权成像(DWI)结合液体衰减翻转恢复(FLAIR)序列、三维动脉自旋标记成像(3D ASL)双不匹配技术对不明发病时间急性脑梗死(ACI)患者的应用价值。方法选取我院进行3.0T磁共振DWI、FLAIR、3D ASL、磁共振血管成像(MRA)扫描的不明时间窗的急性脑梗死患者35例,并同时满足DWI高信号且FLAIR在相应的DWI高信号区未显影及DWI高信号、3D ASL存在灌注减低区且灌注减低区/DWI高信号区>1.2双不匹配,并存在大血管闭塞患者。同时选取明确发病时间窗内(<4.5 h)急性脑梗死患者35例,进行再灌注治疗。比较两组患者治疗前及治疗后24 h NIHSS评分、两组90 d mRS评分及颅内出血的发生率。结果双不匹配组与明确时间窗组治疗前后24 h NIHSS评分比较有显著性差异(P<0.05)。90 d mRS比较无显著性差异(P>0.05)。结论DWI-FLAIR、DWI-3D ASL双不匹配可作为不明发病时间急性脑梗死患者发病时间、缺血半暗带及再灌注情况的有效评估手段,为静脉溶栓、桥接治疗以及保守治疗提供依据。展开更多
To evaluate the reliability of three dimensional spiral fast spin echo pseudo-continuous arterial spin labeling(3D pc-ASL)in measuring cerebral blood flow(CBF)with different post-labeling delay time(PLD)in the resting...To evaluate the reliability of three dimensional spiral fast spin echo pseudo-continuous arterial spin labeling(3D pc-ASL)in measuring cerebral blood flow(CBF)with different post-labeling delay time(PLD)in the resting state and the right finger taping state.Methods 3D pc-ASL and three dimensional T1-weighted fast spoiled gradient recalled echo(3D T1-FSPGR)sequence were applied to eight healthy subjects twice at the same time each day for one week interval.ASL data acquisition was performed with post-labeling delay time(PLD)1.5 seconds and 2.0 seconds in the resting state and the right finger taping state respectively.CBF mapping was calculated and CBF value of both the gray matter(GM)and white matter(WM)was automatically extracted.The reliability was evaluated using the intraclass correlation coefficient(ICC)and Bland and Altman plot.Results ICC of the GM(0.84)and WM(0.92)was lower at PLD 1.5 seconds than that(GM,0.88;WM,0.94)at PLD 2.0 seconds in the resting state,and ICC of GM(0.88)was higher in the right finger taping state than that in the resting state at PLD 1.5 seconds.ICC of the GM and WM was 0.71 and 0.78 for PLD 1.5 seconds and PLD 2.0 seconds in the resting state at the first scan,and ICC of the GM and WM was 0.83 and 0.79 at the second scan,respectively.Conclusion This work demonstrated that 3D pc-ASL might be a reliable imaging technique to measure CBF over the whole brain at different PLD in the resting state or controlled state.展开更多
Conventional neuroimaging techniques cannot truly reflect the change of regional cerebral blood flow in patients with carpal tunnel syndrome.Pseudo-continuous arterial spinning labeling(pCASL)as an efficient non-invas...Conventional neuroimaging techniques cannot truly reflect the change of regional cerebral blood flow in patients with carpal tunnel syndrome.Pseudo-continuous arterial spinning labeling(pCASL)as an efficient non-invasive neuroimaging technique can be applied to directly quantify the neuronal activities of individual brain regions that show the persistent symptoms owing to its better spatial resolution and increased signal-to-noise ratio.Therefore,this prospective observational study was conducted in 27 eligible female carpal tunnel syndrome,aged 57.7±6.51 years.Psychometric tests,nerve conduction studies and pCASL neuroimaging assessment were performed.The results showed that the relevant activated brain regions in the cortical,subcrotical,and cerebral regions were correlated with numbness,pain,functionality,median nerve status and motor amplitude of median nerve(K=21–2849,r=–0.77–0.76,P<0.05).There was a tendency of pain processing which shifted from the nociceptive circuitry to the emotional and cognitive one during the process of chronic pain caused by carpal tunnel syndrome.It suggests the necessity of addressing the ignored cognitive or emotional state when managing patients with carpal tunnel syndrome.Approval for this study was obtained from the Institutional Review Board of The University of Hong Kong/Hospital Authority Hong Kong West,China(HKU/HA HKW IRB,approval No.UW17-129)on April 11,2017.This study was registered in Clinical Trial Registry of The University of Hong Kong,China(registration number:HKUCTR-2220)on April 24,2017.展开更多
文摘目的探讨3.0T磁共振弥散加权成像(DWI)结合液体衰减翻转恢复(FLAIR)序列、三维动脉自旋标记成像(3D ASL)双不匹配技术对不明发病时间急性脑梗死(ACI)患者的应用价值。方法选取我院进行3.0T磁共振DWI、FLAIR、3D ASL、磁共振血管成像(MRA)扫描的不明时间窗的急性脑梗死患者35例,并同时满足DWI高信号且FLAIR在相应的DWI高信号区未显影及DWI高信号、3D ASL存在灌注减低区且灌注减低区/DWI高信号区>1.2双不匹配,并存在大血管闭塞患者。同时选取明确发病时间窗内(<4.5 h)急性脑梗死患者35例,进行再灌注治疗。比较两组患者治疗前及治疗后24 h NIHSS评分、两组90 d mRS评分及颅内出血的发生率。结果双不匹配组与明确时间窗组治疗前后24 h NIHSS评分比较有显著性差异(P<0.05)。90 d mRS比较无显著性差异(P>0.05)。结论DWI-FLAIR、DWI-3D ASL双不匹配可作为不明发病时间急性脑梗死患者发病时间、缺血半暗带及再灌注情况的有效评估手段,为静脉溶栓、桥接治疗以及保守治疗提供依据。
基金Supported by the Foundation for Medical and Health Sci&Tech Innovation Project of Sanya(2016YW37)the Special Financial Grant from China Postdoctoral Science Foundation(2014T70960)
文摘To evaluate the reliability of three dimensional spiral fast spin echo pseudo-continuous arterial spin labeling(3D pc-ASL)in measuring cerebral blood flow(CBF)with different post-labeling delay time(PLD)in the resting state and the right finger taping state.Methods 3D pc-ASL and three dimensional T1-weighted fast spoiled gradient recalled echo(3D T1-FSPGR)sequence were applied to eight healthy subjects twice at the same time each day for one week interval.ASL data acquisition was performed with post-labeling delay time(PLD)1.5 seconds and 2.0 seconds in the resting state and the right finger taping state respectively.CBF mapping was calculated and CBF value of both the gray matter(GM)and white matter(WM)was automatically extracted.The reliability was evaluated using the intraclass correlation coefficient(ICC)and Bland and Altman plot.Results ICC of the GM(0.84)and WM(0.92)was lower at PLD 1.5 seconds than that(GM,0.88;WM,0.94)at PLD 2.0 seconds in the resting state,and ICC of GM(0.88)was higher in the right finger taping state than that in the resting state at PLD 1.5 seconds.ICC of the GM and WM was 0.71 and 0.78 for PLD 1.5 seconds and PLD 2.0 seconds in the resting state at the first scan,and ICC of the GM and WM was 0.83 and 0.79 at the second scan,respectively.Conclusion This work demonstrated that 3D pc-ASL might be a reliable imaging technique to measure CBF over the whole brain at different PLD in the resting state or controlled state.
文摘Conventional neuroimaging techniques cannot truly reflect the change of regional cerebral blood flow in patients with carpal tunnel syndrome.Pseudo-continuous arterial spinning labeling(pCASL)as an efficient non-invasive neuroimaging technique can be applied to directly quantify the neuronal activities of individual brain regions that show the persistent symptoms owing to its better spatial resolution and increased signal-to-noise ratio.Therefore,this prospective observational study was conducted in 27 eligible female carpal tunnel syndrome,aged 57.7±6.51 years.Psychometric tests,nerve conduction studies and pCASL neuroimaging assessment were performed.The results showed that the relevant activated brain regions in the cortical,subcrotical,and cerebral regions were correlated with numbness,pain,functionality,median nerve status and motor amplitude of median nerve(K=21–2849,r=–0.77–0.76,P<0.05).There was a tendency of pain processing which shifted from the nociceptive circuitry to the emotional and cognitive one during the process of chronic pain caused by carpal tunnel syndrome.It suggests the necessity of addressing the ignored cognitive or emotional state when managing patients with carpal tunnel syndrome.Approval for this study was obtained from the Institutional Review Board of The University of Hong Kong/Hospital Authority Hong Kong West,China(HKU/HA HKW IRB,approval No.UW17-129)on April 11,2017.This study was registered in Clinical Trial Registry of The University of Hong Kong,China(registration number:HKUCTR-2220)on April 24,2017.
