应用灌注磁共振技术评价缺血性脑血管病的外科治疗价值

选择2012年7月～2013年8月在我院进行PWI检查的20例缺血性脑血管疾病患者为研究对象，均在术前实施MRI、DSA与PWI检查，针对本组患者的检查结果进行详细的记录与分析。 PWI检查结果显示，14例患者MTT升高、rCBF正常，6例患者MTT升高，rCBF降低。本组20例患者均接受手术治疗，其中12例接受支架血管成形术，5例接受颈动脉内膜切除术，3例接受颞浅动脉-大脑中动脉吻合术，20例患者均顺利的完成手术，在手术围期未出现并发症。 PWI可以清晰的显示出缺血性脑血管病患者的血流动力情况，能够为外科治疗提供科学有效的评价指标，该种技术是值得在临床中进行推广和使用的。

增强核磁共振肺灌注扫描技术与增强核磁共振肺动脉造影术对肺动脉栓塞的诊断价值对比分析

目的探讨增强核磁共振灌注扫描技术(MRPP)与增强核磁共振肺动脉造影术(MRPA)对于肺动脉栓塞患者诊断的敏感度与特异度差异,比较两者诊断的临床价值。方法对我院自2010年12月至2013年6月期间收治的32例确诊肺动脉栓塞患者的临床资料进行分析。均对其行增强核磁共振灌注扫描术与增强核磁共振肺动脉造影术,其中10例患者同时行核素肺灌注扫描,另有7例患者在经过溶栓治疗以后,对其进行MRPP以及MRPA的复查。检查时在患者的异常区域以及上部、中部以及下部肺动脉病变区域设置感兴趣区(ROI),对信号-时间曲线、信号强度(SI)进行测量,从而获得血流灌注高峰时段信号强度的变化率(TROS)。结果对上述32例肺动脉栓塞患者行MRPA,发现共有137条肺动脉出现闭塞,行MRPP后发现共有125个肺部血流灌注异常区域和MRPA结果吻合,吻合率为91.24%。32例肺动脉栓塞患者在MRPP检查中发现有57个肺动脉段合并段以远及段的动脉栓塞。10例同时行核素肺灌注扫描患者结果表明,共有81个肺动脉段灌注缺损,而此时MRPA检查结果显示77个肺段受到累及,敏感度为95.06%,MRPP检查结果显示73个肺段受累,敏感度为90.12%。结论 MRPP对于肺动脉诊断的敏感度显著低于MRPA,MRPP以及MRPA都有可以有效观察区别肺动脉栓塞的低灌注区和灌注缺损区。

增强核磁共振肺灌注扫描技术与增强核磁共振肺动脉造影术对肺动脉栓塞的诊断价值

目的探究对肺动脉栓塞诊断时应用增强核磁共振肺灌注扫描技术(MRPP)与增强核磁共振肺动脉造影术(MRPA)的诊断价值。方法 80例肺动脉栓塞患者作为本次研究对象,按照患者所接受的检查方法不同将其分为MRPP组和MRPA组,各40例。比较两组患者实施对应检查的检查结果。结果 MRPA组的诊断准确率为97.12%,高于MRPP组的89.29%,差异有统计学意义(P<0.05)。结论增强核磁共振肺灌注扫描技术与增强核磁共振肺动脉造影术均可对肺动脉栓塞情况作出诊断,但是增强核磁共振肺动脉造影术的准确率更高,因此推荐临床优先选择应用。

磁共振弥散及灌注成像技术应用于急性脑梗死早期诊断中的应用比较

目的:探究和分析磁共振弥散及灌注成像技术应用于急性脑梗死早期诊断中的临床价值对比。方法:选取在2018年8月到2018年12月在我院诊疗的90例急性脑梗死患者,按照随机化分配的原则分为两组,实验组和对照组的患者各45例,对照组采取磁共振弥散加权成像技术,实验组采取磁共振灌注成像技术,对比两组急性脑梗死的诊断结果准确率数据。结果:与对照组相比,实验组对急性脑梗死患者的诊断率较高,数据差异具有统计学意义(P<0.05)。结论:磁共振弥散及灌注成像技术应用于急性脑梗死早期诊断,具有较好的临床应用价值,早期诊断准确率都尚可,灌注成像技术相比较准确率更高,可在临床治疗中作为首选方案。

利用磁共振灌注成像技术分析动脉血氧分压的变化对COPD患者脑灌注减低区灌注参数值的影响

目的:研究利用磁共振灌注成像技术分析动脉血氧分压的变化对慢性阻塞性肺疾病(C O P D)患者脑灌注减低区灌注参数值的影响。方法:抽取昆明市中医医院于2019年7月—2020年10月门诊及住院收治的COPD并低氧血症患者30例,均采用磁共振灌注成像技术检查方式,观察治疗前后患者的灌注成像参数值与动脉血PaO2的相关性等。结果:与治疗前相比,COPD并低氧血症患者治疗后的RCBF、RCBV值水平更高(P<0.05),MTT水平稍降低。与治疗前相比,COPD并低氧血症患者治疗后的PaO2水平更高(P<0.05)。全部COPD并低氧血症患者的RCBF、RCBV参数与PaO2呈正相关,而MTT参数与PaO2相关性不高。结论:低氧血症能造成局部脑组织微循环灌注减低,产生缺血、缺氧改变,如进一步加重则可进展为缺血梗死灶,低灌注区RCBF、RCBV值下降,MTT稍延长,经过临床及时治疗纠正低氧血症后复查PWI,原低灌注区RCBF、RCBV值升高恢复正常范围,MTT亦稍缩短至正常范围,证明磁共振灌注成像技术对于推断脑组织低灌注区损害的可逆程度、指导早期予以治疗等有十分重要的意义。

EVALUATION OF CIRRHOTIC LIVER WITH PERFUSION-WEIGHTED MAGNETIC RESONANCE IMAGING:A PRELIMINARY EXPERIMENTAL STUDY IN ANIMAL MODELS WITH HALF-LIVER CIRRHOSIS

Objective To investigate the role of peffusion-weighted magnetic resonance imaging （MRI） in evaluation of cirrhotic fiver. Methods With a 4F catheter, 1% diluted carbon tetrachloride （ 1 ml/kg） was selectively injected into fight or left hepatic artery of 12 dogs fortnightly. The half fiver into which carbon tetrachloride was injected was called as study side （SS）, while the other half fiver without carbon tetrachloride injection was called as study control side （SCS）. Conventional and peffusion-weighted MRI were performed in every 4 weeks. Via a 4F catheter, 5ml gadolinium diethylentriamine pentaaceti acid （Gd-DTPA） dilution was injected into superior mesenteric artery at the 5th scan. The signal intensity-thne curves of SS, SCS, and portal vein were completed in MR workstation. The maximal relative signal increase （ MRSI）, peak time （ tp）, and slope of the curves were measured. Results On conventional MR images, no abnormalities of externality and signal intensity were observed in both SS and SCS of fiver at each stage. The mean tp, MP, SI, and slope of intensity-time curves in normal fiver were 10. 56 seconds, 1.01, and 10. 23 arbitrary unit （au）/s, respectively. Three parameters of curves didn＇t show obvious change in SCS of fiver at every stage. Abnormal perfusion curves occurred in SS of fiver at the 12th week after the 1st injection. The abnormality of perfusion curve in SS was more and more serious as the times of injection increased. The mean tp, IVlRSI, and slope intensity-time curves in SS of fiver were 19.45 seconds, 0. 43, and 3. 60 au/s respectively at the 24th week. Conclusion Perfusion-weighted imaging can potentially provide information about portal peffusion of hepatic parenchyma, and to some degree, reflect the severity of cirrhosis.

DIFFERENCES IN INTERICTAL PERFUSION PATTERNS BETWEEN REFRACTORY AND NON-REFRACTORY TEMPORAL LOBE EPILEPSIES EVALUATED WITH FAIR AT 3.0T

Objective To investigate the difference in interictal perfusion patterns between refractory and non-refractory temporal lobe epilepsies evaluated with flow-sensitive alternating inversion recovery (FAIR) magnetic resonance (MR) sequence. Methods Nine patients with refractory temporal lobe epilepsy, 21 patients with non-refractory temporal lobe epilepsy, and 13 normal volunteers underwent FAIR MR scanning. The relative cerebral blood flow (rCBF) in bilateral hemispheres and mesial temporal lobes were measured. And we also calculated the asymmetry index (AI) values. Results The AI values of bilateral hemispheres in refractory and non-refractory epilepsy patients were both significantly different from those of volunteers (P=0.012 and 0.029, respectively). There was significant difference in AI values of bilateral mesial temporal lobes between non-refractory epilepsy patients and volunteers (P=0.049), while no significant difference between refractory epilepsy patients and volunteers. Conclusions The hypoperfusion pattern of interictal refractory temporal lobe epilepsy patients is different from that of non-refractory patients. Although the hypoperfusion tends to extend out of temporal lobes in all patients, the refractory epilepsy patients have a preference of bilateral mesial temporal hypoperfusion, which may be valuable for evaluating prognosis.