3D-ASL灌注技术在缺血性脑血管疾病中的应用价值

目的研究三维动脉自旋标记(3D-ASL)灌注技术在缺血性脑血管疾病中的应用价值。方法选取2018年7月至2019年4月于我院就诊的缺血性脑血管疾病患者22例,同时选取同期22例健康正常人为对照组。所有患者均常规进行MR、MRA和DWI检查。结果 3D-ASL脑血流灌注中对照组20例(90.91%)正常灌注,2例(9.09%)灌注减低,平均rCBF比值为(1.02±1.20)。病例组8例(36.36%)正常灌注,14例(63.64%)灌注减低,平均rCBF比值为(0.49±0.14)。对照组平均rCBF比值明显高于病例组(P<0.05)。对照组中MRA出现狭窄血管有3例(13.64%),灌注减低有2例(9.09%),MRA联合3D-ASL出现异常有3例(13.64%)。病例组中MRA出现狭窄血管有12例(54.55%),灌注减低有14例(63.64%),MRA联合3D-ASL出现异常有18例(81.82%),提示M RA联合3 D-ASL诊断的敏感性明显高于MRA或3D-ASL。病例分析中3D-ASL显示大脑半球血流量右侧多于左侧,3D-ASL显示复查后部分恢复左侧大脑半球血流量,减轻缺血症状。3 D-ASL显示左侧大脑中动脉供血区血流量广泛减少。于溶栓治疗1天后复查,3D-ASL显示原大脑中动脉供血血流灌注减低区基本恢复,于1个月后进行复查,3D-ASL显示左侧颞叶梗死灶范围明显缩小。结论与常规MR检查技术比较,3D-ASL技术可发现其无法发现的病变,且对缺血性脑血管疾病血流灌注状态可全面反映,可动态观察血流灌注恢复状态,对于临床诊断治和预后判断具有重要的指导意义,联合应用3D-ASL和MRA可使3D-ASL诊断价值提高。

Application Value of 3D-ASL Perfusion Technique in Ischemic Cerebrovascular Diseases

Objective To study the application value of three-dimension arterial spin labeling(3 D-ASL) perfusion technique in ischemic cerebrovascular diseases.Methods Twenty-two patients with ischemic cerebrovascular disease who were treated in our hospital from May to April 2019 were enrolled.22 healthy healthy subjects were selected as the control group.MR,MRA,and DWI were routinely performed in all patients.Results In the 3 D-ASL cerebral blood perfusion,20 patients(90.91%) in the control group underwent normal perfusion,and 2 patients(9.09%) underwent perfusion.The mean rCBF ratio was(1.02±1.20).In the case group,8 patients(36.36%) underwent normal perfusion,and 14 patients(63.64%) had reduced perfusion.The average rCBF ratio was(0.4910.14).The mean rCBF ratio of the control group was significantly higher than that of the case group(P<0.05).In the control group,there were 3 cases(13.64%) with stenotic vessels,2 cases(9.09%) with hypoperfusion,and 3 cases(13.64%) with MRA and 3 D-ASL.There were 12 cases(54.55%) with stenotic vessels in the MRA,14 cases(63.64%) with reduced perfusion,and 18 cases(81.82%) with abnormalities in MRA and 3 D-ASL.It is suggested that the sensitivity of MRA combined with 3 D-ASL diagnosis is significantly higher than that of MRA or 3 D-ASL.In the case analysis,3 D-ASL showed that the cerebral hemisphere blood flow was more on the right side than on the left side.3 D-ASL showed that the left cerebral hemisphere blood flow was partially restored after the review,and the ischemic sym ptoms were alleviated.3 D-ASL showed a wide reduction in blood flow in the left middle cerebral artery supply area.After 1 day of thrombolytic therapy,3 D-ASL showed a substantial recovery of the original middle cerebral artery blood supply perfusion reduction zone,and the left temporal lobe infarct area showed a significant high signal.After 1 month,the 3 D-ASL showed a significa nt reduction of the left temporal lobe.Infa rct size range.Conclusion Compared with conventional MR examination,3 D-ASL can detect the lesions that can not be found,and can reflect the blood perfusion status of ischemic cerebrovascular disease.It can dynamically observe the state of blood perfusion recovery,for clinical diagnosis and prognosis.Judging has important guiding significance,and the combined application of 3 D-ASL and MRA can improve the diagnostic value of 3 D-ASL.