BACKGROUND Early thrombolytic therapy is crucial to treat acute cerebral infarction,especially since the onset of thrombolytic therapy takes 1-6 h.Therefore,early diagnosis and evaluation of cerebral infarction is imp...BACKGROUND Early thrombolytic therapy is crucial to treat acute cerebral infarction,especially since the onset of thrombolytic therapy takes 1-6 h.Therefore,early diagnosis and evaluation of cerebral infarction is important.AIM To investigate the diagnostic value of magnetic resonance multi-delay threedimensional arterial spin labeling(3DASL)and diffusion kurtosis imaging(DKI)in evaluating the perfusion and infarct area size in patients with acute cerebral ischemia.METHODS Eighty-four patients who experienced acute cerebral ischemia from March 2019 to February 2021 were included.All patients in the acute stage underwent magnetic resonance-based examination,and the data were processed by the system’s own software.The apparent diffusion coefficient(ADC),average diffusion coefficient(MD),axial diffusion(AD),radial diffusion(RD),average kurtosis(MK),radial kurtosis(fairly RK),axial kurtosis(AK),and perfusion parameters post-labeling delays(PLD)in the focal area and its corresponding area were compared.The correlation between the lesion area of cerebral infarction under MK and MD and T2-weighted imaging(T2WI)was analyzed.RESULTS The DKI parameters of focal and control areas in the study subjects were compared.The ADC,MD,AD,and RD values in the lesion area were significantly lower than those in the control area.The MK,RK,and AK values in the lesion area were significantly higher than those in the control area.The MK/MD value in the infarct lesions was used to determine the matching situation.MK/MD<5 mm was considered matching and MK/MD≥5 mm was considered mismatching.PLD1.5s and PLD2.5s perfusion parameters in the central,peripheral,and control areas of the infarct lesions in MK/MD-matched and-unmatched patients were not significantly different.PLD1.5s and PLD2.5s perfusion parameter values in the central area of the infarct lesions in MK/MD-matched and-unmatched patients were significantly lower than those in peripheral and control areas.The MK and MD maps showed a lesion area of 20.08±5.74 cm^(2) and 22.09±5.58 cm^(2),respectively.T2WI showed a lesion area of 19.76±5.02 cm^(2).There were no significant differences in the cerebral infarction lesion areas measured using the three methods.MK,MD,and T2WI showed a good correlation.CONCLUSION DKI parameters showed significant difference between the focal and control areas in patients with acute ischemic cerebral infarction.3DASL can effectively determine the changes in perfusion levels in the lesion area.There was a high correlation between the area of the infarct lesions diagnosed by DKI and T2WI.展开更多
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
文摘BACKGROUND Early thrombolytic therapy is crucial to treat acute cerebral infarction,especially since the onset of thrombolytic therapy takes 1-6 h.Therefore,early diagnosis and evaluation of cerebral infarction is important.AIM To investigate the diagnostic value of magnetic resonance multi-delay threedimensional arterial spin labeling(3DASL)and diffusion kurtosis imaging(DKI)in evaluating the perfusion and infarct area size in patients with acute cerebral ischemia.METHODS Eighty-four patients who experienced acute cerebral ischemia from March 2019 to February 2021 were included.All patients in the acute stage underwent magnetic resonance-based examination,and the data were processed by the system’s own software.The apparent diffusion coefficient(ADC),average diffusion coefficient(MD),axial diffusion(AD),radial diffusion(RD),average kurtosis(MK),radial kurtosis(fairly RK),axial kurtosis(AK),and perfusion parameters post-labeling delays(PLD)in the focal area and its corresponding area were compared.The correlation between the lesion area of cerebral infarction under MK and MD and T2-weighted imaging(T2WI)was analyzed.RESULTS The DKI parameters of focal and control areas in the study subjects were compared.The ADC,MD,AD,and RD values in the lesion area were significantly lower than those in the control area.The MK,RK,and AK values in the lesion area were significantly higher than those in the control area.The MK/MD value in the infarct lesions was used to determine the matching situation.MK/MD<5 mm was considered matching and MK/MD≥5 mm was considered mismatching.PLD1.5s and PLD2.5s perfusion parameters in the central,peripheral,and control areas of the infarct lesions in MK/MD-matched and-unmatched patients were not significantly different.PLD1.5s and PLD2.5s perfusion parameter values in the central area of the infarct lesions in MK/MD-matched and-unmatched patients were significantly lower than those in peripheral and control areas.The MK and MD maps showed a lesion area of 20.08±5.74 cm^(2) and 22.09±5.58 cm^(2),respectively.T2WI showed a lesion area of 19.76±5.02 cm^(2).There were no significant differences in the cerebral infarction lesion areas measured using the three methods.MK,MD,and T2WI showed a good correlation.CONCLUSION DKI parameters showed significant difference between the focal and control areas in patients with acute ischemic cerebral infarction.3DASL can effectively determine the changes in perfusion levels in the lesion area.There was a high correlation between the area of the infarct lesions diagnosed by DKI and T2WI.
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。
