MR 3D-ASL联合MRA诊断TIA的价值分析

目的探讨磁共振三维动脉自旋标记(MR 3D-ASL)技术联合磁共振血管成像(MRA)诊断短暂性脑缺血发作(TIA)的价值。方法回顾性分析2015年6月至2018年6月于我院确诊的72例TIA患者的临床资料。所有患者均接受MRA和MR 3D-ASL检查,观察MRA图像中血管形态和MR 3D-ASL图像中灌注异常情况,检测异常区和对侧镜像区相对脑血流量(rCBF)值,比较两者联合检查和单一检查诊断TIA的准确性。结果MRA与3D-ASL诊断TIA的准确率比较差异无统计学意义(χ^2=0.120,P>0.05),两者联合检查准确率明显高于MRA、3D-ASL单一检查(χ^2=5.763、4.255,P<0.05);3D-ASL定量分析显示,灌注异常区ROI的rCBF为(26.41±8.06)m L/(100 g˙min),明显低于对侧镜像区域(37.59±10.25)mL/(100g˙min)],差异有统计学意义(t=7.275,P<0.05)。结论MR3D-ASL和MRA可分别显示灌注异常和血管异常,对TIA均有一定的诊断价值,且MR 3D-ASL能定量分析TIA患者脑组织血液灌注程度,两者联合应用可明显提高TIA的诊断准确率。

Value of MR3D-ASL Combined with MRA in the Diagnosis of TIA

Objective To explore the value of magnetic resonance three-dimensional arterial spin labeling(MR 3D-ASL)combined with magnetic resonance angiography(MRA)in the diagnosis of transient ischemic attack(TIA).Methods The clinical data of 72 patients with TIA diagnosed in our hospital from June 2015 to June 2018 were retrospectively analyzed.All patients were given MRA and MR 3D-ASL examination.The vascular morphology in MRA images and perfusion abnormalities in MR 3D-ASL images were observed.The relative cerebral blood flow(rCBF)values was detected in the abnormal area and the contralateral mirror area.The accuracy of combined examination and a single examination for TIA was compared.Results There was no significant difference in the accuracy rate of MIA and 3D-ASL in the diagnosis of TIA(χ^2=0.120,P>0.05),and the accuracy rate of combined examination was significantly higher than that of single MRA or 3D-ASL(χ^2=5.763,4.255,P<0.05).3D-ASL quantitative analysis showed that the rCBF of ROI in the perfusion abnormal area was(26.41±8.06)mL/(100g·min),which was significantly lower than that in the contralateral mirror area with(37.59±10.25)mL/(100g·min)(t=7.275,P<0.05).Conclusion MR 3D-ASL and MRA can show perfusion abnormalities and vascular abnormalities,respectively,and they have spectific diagnostic value for TIA.MR3D-ASL can quantitatively analyze the blood perfusion of brain tissues in TIA patients,and the combination of the two can significantly improve the diagnostic accuracy rate for TIA.