目的探讨磁共振三维动脉自旋标记脑灌注成像(3D ASL)中不同标记后延迟时间(PLD)对急性脑梗死不同脑区血流量的影响。方法随机选取基底节区新发脑梗死患者15例,采用不同标记后延迟时间(PLD=1.5s和PLD=2.5s)进行3D-ASL检查。通过GE AW 4....目的探讨磁共振三维动脉自旋标记脑灌注成像(3D ASL)中不同标记后延迟时间(PLD)对急性脑梗死不同脑区血流量的影响。方法随机选取基底节区新发脑梗死患者15例,采用不同标记后延迟时间(PLD=1.5s和PLD=2.5s)进行3D-ASL检查。通过GE AW 4.6后处理工作站,分别获得不同PLD时间点的全脑血流量(CBF)图,选取双侧额、颞、顶、枕叶、小脑和基底节区为感兴趣区,其中基底节区选取弥散加权成像(DWI)上高信号梗死区域,测量患侧和对侧镜像区域的CBF值。采用配对t检验分析不同PLD时间各脑区CBF值之间的差异,以及相同PLD的各脑区患侧和对侧CBF值之间的差异。P值小于0.05为有统计学显著差异。结果不同PLD时间点比较发现,额、颞、顶、枕叶及小脑半球区域CBF值在PLD=1.5s均低于PLD=2.5s,具有统计学显著差异(P均<0.05);基底节区域的CBF值在PLD=1.5s和PLD=2.5s无统计学显著差异。相同PLD的各脑区患侧和对侧CBF值比较发现,在PLD=1.5s或2.5s,颞、顶、枕叶及小脑半球区域患侧与对侧的CBF值均无统计学显著差异;而额叶的患侧与对侧的CBF值在PLD=1.5s有统计学显著差异(P<0.05),在PLD=2.5s无统计学显著差异;基底节区的患侧与对侧的CBF值在两种不同的延迟时间均有统计学显著差异(P均<0.05)。结论急性脑梗死患者3D ASL成像不同PLD时间对脑血流量的定量分析具有重要影响,合理选择PLD时间参数有助于准确评估急性脑梗死的全脑血流灌注情况。展开更多
Objective: To determine the protective effect of monosialoganglionside (GM1) and evaluate the influence of GM1 on expression of N-methyl-D-aspartate receptor subunit 1 (NMDAR1) in Sprague-Dawley (SD) rats with focal c...Objective: To determine the protective effect of monosialoganglionside (GM1) and evaluate the influence of GM1 on expression of N-methyl-D-aspartate receptor subunit 1 (NMDAR1) in Sprague-Dawley (SD) rats with focal cerebral ische- mia-reperfusion (I/R). Methods: Left middle cerebral artery (MCA) was occluded by an intraluminal suture for 1 h and the brain was reperfused for 72 h in SD rats when infarct volume was measured, GM1 (10 mg/kg) was given ip (intraperitoneally) at 5 min (group A), 1 h (group B) and 2 h (group C) after MCA occlusion (MCAo). Expression of NMDAR1 was detected by Western blot at various time after reperfusion (4 h, 6 h, 24 h, 48 h and 72 h) in ischemic hemispheres of the rats with or without GM1 admin- istered. Results: (1) Adjusted relative infarct volumes of groups A and B were significantly smaller than that of group C and the control group (P<0.01 and P<0.05, respectively). (2) Expression level of NMDAR1 was temporally high at 6 h after reperfusion, and dipped below the normal level at 72 h after reperfusion. GM1 at 5 min after MCAo significantly suppressed the expression of NMDAR1 at 6 h after reperfusion (P<0.05 vs the control). At 72 h after reperfusion, the NMDAR1 expression level of rats treated with GM1 administered (at 5 min or 2 h after MCAo) was significantly higher than that of the control (P<0.05). Conclusion: GM1 can time-dependently reduce infarct volume in rats with focal cerebral I/R partly through stabilizing the expression of NMDAR1.展开更多
OBJECTIVE: To explore the management of cerebral ischemia caused by Takayasu's arteritis. METHODS: Ninety-three cases treated from June 1984 to September 1999 at the General Post & Telecom Hospital, the Sir Ru...OBJECTIVE: To explore the management of cerebral ischemia caused by Takayasu's arteritis. METHODS: Ninety-three cases treated from June 1984 to September 1999 at the General Post & Telecom Hospital, the Sir Run Run Shaw Hospital, the First Affiliated Hospital of Zhejiang University, the Second Medical College of Beijing University, Beijing An Zhen Hospital, and the Beijing Union Medical College Hospital, including 10 men and 83 women, were reviewed. Of the 93 cases, bypasses from the ascending aorta to the axillary or subclavian artery and from graft to the carotid artery were performed in 47 cases. Subclavian to carotid bypass was performed in six cases. Percutaneous transluminal angioplasty (PTA) was used in five cases and stenting in one. RESULTS: Marked improvement was achieved in 30.3%, fair in 34.9%, improvement in 21.2%, unchanged in 4.6%, and death in 9.0% before discharge; 30.6%, 38.8%, 16.3%, 4.1%, and 2.0% respectively during a mean follow-up of 48 months, and recurrence requiring revision in 8.2%. CONCLUSION: Patients with occlusive lesions of all four cervical arteries always have severe cerebral ischemia and their distal runoff is always unvisualised by angiography. However, we found by exploration that the internal carotid artery is patent in all but one patient. Therefore, an ascending aorta to carotid bypass is feasible in most instances, and this can and should be done when the cerebral perfusion is jeopardized at a time when the patient is in a stable or relatively stable condition. Unfortunately, the cerebral re-perfusion syndrome is still a serious and not completely solved problem.展开更多
文摘目的探讨磁共振三维动脉自旋标记脑灌注成像(3D ASL)中不同标记后延迟时间(PLD)对急性脑梗死不同脑区血流量的影响。方法随机选取基底节区新发脑梗死患者15例,采用不同标记后延迟时间(PLD=1.5s和PLD=2.5s)进行3D-ASL检查。通过GE AW 4.6后处理工作站,分别获得不同PLD时间点的全脑血流量(CBF)图,选取双侧额、颞、顶、枕叶、小脑和基底节区为感兴趣区,其中基底节区选取弥散加权成像(DWI)上高信号梗死区域,测量患侧和对侧镜像区域的CBF值。采用配对t检验分析不同PLD时间各脑区CBF值之间的差异,以及相同PLD的各脑区患侧和对侧CBF值之间的差异。P值小于0.05为有统计学显著差异。结果不同PLD时间点比较发现,额、颞、顶、枕叶及小脑半球区域CBF值在PLD=1.5s均低于PLD=2.5s,具有统计学显著差异(P均<0.05);基底节区域的CBF值在PLD=1.5s和PLD=2.5s无统计学显著差异。相同PLD的各脑区患侧和对侧CBF值比较发现,在PLD=1.5s或2.5s,颞、顶、枕叶及小脑半球区域患侧与对侧的CBF值均无统计学显著差异;而额叶的患侧与对侧的CBF值在PLD=1.5s有统计学显著差异(P<0.05),在PLD=2.5s无统计学显著差异;基底节区的患侧与对侧的CBF值在两种不同的延迟时间均有统计学显著差异(P均<0.05)。结论急性脑梗死患者3D ASL成像不同PLD时间对脑血流量的定量分析具有重要影响,合理选择PLD时间参数有助于准确评估急性脑梗死的全脑血流灌注情况。
基金Project (No. 2004QN012) supported by the Youth Talent SpecialFund of Health Bureau of Zhejiang Province the National BasicResearch Program (973) of China (No. G1999054000) and the Na-tional Natural Science Foundation of China (No. 30371637)
文摘Objective: To determine the protective effect of monosialoganglionside (GM1) and evaluate the influence of GM1 on expression of N-methyl-D-aspartate receptor subunit 1 (NMDAR1) in Sprague-Dawley (SD) rats with focal cerebral ische- mia-reperfusion (I/R). Methods: Left middle cerebral artery (MCA) was occluded by an intraluminal suture for 1 h and the brain was reperfused for 72 h in SD rats when infarct volume was measured, GM1 (10 mg/kg) was given ip (intraperitoneally) at 5 min (group A), 1 h (group B) and 2 h (group C) after MCA occlusion (MCAo). Expression of NMDAR1 was detected by Western blot at various time after reperfusion (4 h, 6 h, 24 h, 48 h and 72 h) in ischemic hemispheres of the rats with or without GM1 admin- istered. Results: (1) Adjusted relative infarct volumes of groups A and B were significantly smaller than that of group C and the control group (P<0.01 and P<0.05, respectively). (2) Expression level of NMDAR1 was temporally high at 6 h after reperfusion, and dipped below the normal level at 72 h after reperfusion. GM1 at 5 min after MCAo significantly suppressed the expression of NMDAR1 at 6 h after reperfusion (P<0.05 vs the control). At 72 h after reperfusion, the NMDAR1 expression level of rats treated with GM1 administered (at 5 min or 2 h after MCAo) was significantly higher than that of the control (P<0.05). Conclusion: GM1 can time-dependently reduce infarct volume in rats with focal cerebral I/R partly through stabilizing the expression of NMDAR1.
文摘OBJECTIVE: To explore the management of cerebral ischemia caused by Takayasu's arteritis. METHODS: Ninety-three cases treated from June 1984 to September 1999 at the General Post & Telecom Hospital, the Sir Run Run Shaw Hospital, the First Affiliated Hospital of Zhejiang University, the Second Medical College of Beijing University, Beijing An Zhen Hospital, and the Beijing Union Medical College Hospital, including 10 men and 83 women, were reviewed. Of the 93 cases, bypasses from the ascending aorta to the axillary or subclavian artery and from graft to the carotid artery were performed in 47 cases. Subclavian to carotid bypass was performed in six cases. Percutaneous transluminal angioplasty (PTA) was used in five cases and stenting in one. RESULTS: Marked improvement was achieved in 30.3%, fair in 34.9%, improvement in 21.2%, unchanged in 4.6%, and death in 9.0% before discharge; 30.6%, 38.8%, 16.3%, 4.1%, and 2.0% respectively during a mean follow-up of 48 months, and recurrence requiring revision in 8.2%. CONCLUSION: Patients with occlusive lesions of all four cervical arteries always have severe cerebral ischemia and their distal runoff is always unvisualised by angiography. However, we found by exploration that the internal carotid artery is patent in all but one patient. Therefore, an ascending aorta to carotid bypass is feasible in most instances, and this can and should be done when the cerebral perfusion is jeopardized at a time when the patient is in a stable or relatively stable condition. Unfortunately, the cerebral re-perfusion syndrome is still a serious and not completely solved problem.
