ADC在急性缺血性卒中缺血半暗带判定中的价值

目的:探讨ADC对确定急性缺血性卒中缺血半暗带的价值。方法:选择33例超急性、急性脑梗死患者,采用全自动图像分析系统,以DWI图像计算得到的ADC图作为输入数据,来判断缺血半暗带的存在(简称为ADC方法),并在2～30d内复查T2WI确定最终梗死范围,测量梗死中心区、缺血半暗带及对侧镜像区的扩散变化。结果:梗死中心区与缺血半暗带ADC平均值分别为4.38×10-4 mm2/s、6.81×10-4 mm2/s,rADC平均值分别为0.56及0.85,梗死中心区ADC及rADC均明显降低,缺血半暗带ADC及rADC轻度下降,二者之间差异有统计学意义。结论:ADC方法对确定缺血半暗带具有潜在的临床实用价值,有望成为一种简便易行的确定缺血半暗带的方法。

The value of apparent diffusion coefficient in identifying the putative ischemic penumbra in acute ischemic stroke

Objective： To explore the value of apparent diffusion coefficient（ADC）based approach in determining ischemic pe- numbra. Methods：Thirty-three hyperacute and acute cerebral infarction patients were retrospectively reviewed by diffusion- weighted imaging. An automatic image analysis system based on ADC maps（ADC method for short）was also tested in these pa- tients to explore the presence of ischemic penumbra. All the patients were followed up with T2 WI to determine the final area of infarction within 2 to 30 days. Diffusion changes were measured in the infarct area and ischemic penumbra in the affected hemi- sphere and the counterpart in the contralateral hemisphere. Results：The average value of apparent diffusion coefficient（ADC）in the center of infarction and ischemic penumbra was 4.38 × 10^-4 mm2/s and 6.81 × 10^-4 mm2/s, and that of relative ADC（rADC） was 0.56 and 0.85 ,respectively. There was a significant decline and mild decline in the ADC and rADC value of center of infarc- tion and ischemic penumbra,respectively, and both of the decline had a difference of significance. Conclusions： The ADC based approach may be a feasible and practical tool to determine ischemic penumbra.