3D pCASL灌注成像及Rapid分析对症状性颅内动脉动脉硬化性狭窄危险因素的评估

目的 采用两个标记后延迟时间(post labeling delay, PLD)的三维伪连续动脉自旋标记(three-dimensional pseudo-continuous arterial spin labeling, 3D pCASL)成像和MR灌注成像Rapid软件评估有和无临床症状的2组单侧大脑中动脉M1段狭窄患者的脑血流灌注差异及患者出现临床症状的危险因素。方法 101例单侧大脑中动脉M1段动脉硬化性狭窄患者，均行两个PLD(1.5 s和2.5 s)的3D pCASL及磁共振灌注成像(perfusion weighted imaging, PWI)的Rapid软件分析。建立二元Logistic回归模型，以有无症状作为二分类因变量，将局部动脉狭窄率、狭窄动脉下游的早期到达血流比率(early-arriving flowproportion, EAFP)、晚期到达逆向血流比率(late-arriving retrograde flow proportion, LARFP),低灌注指数比(hypoperfusion intensity ratio, HIR)和患者的年龄、性别、...

Evaluation of risk factors for symptomatic intracranial arterial arteriosclerotic stenosis by 3D pCASL perfusion imaging and Rapid analysis

Objective To assess differences in cerebral blood flow perfusion and risk factors for clinical symptoms in two groups of patients with M1 segment of unilateral middle cerebral artery(MCA) stenosis with and without clinical symptoms by using three-dimensional pseudo-continuous arterial spin labeling(3D pCASL) imaging with two post-labeling delay(PLD) and Rapid software analysis of magnetic resonance perfusion-weighted imaging(PWI).Methods A total of 101 patients with M1 segment of unilateral MCA stenosis who underwent 3D pCASL with two PLD and Rapid soft ware analysis of magnetic resonance perfusion imaging(PWI). Binary logistic regression model was established, the presence or absence of symptoms was used as a binary dependent variable, and the local arterial stenosis rate, early-arriving flow proportion(EAFP),late-arriving retrograde flow proportion(LARFP), hypoperfusion intensity ratio(HIR) of downstream of the stenotic artery, and the patient′s age, gender, smoking history, homocysteine, blood pressure, blood lipids and blood glucose parameters were included in the model for analysis as independent variables.Results Univariate comparison of exposure factors in the symptomatic and asymptomatic group showed significant differences in LARFP and HIR between two groups, and logistic regression analysis of risk factors in patients with symptomatic stenosis after adjusting for EAFP, arterial stenosis rate, and other parameters showed that LARFP and HIR, which represented collateral blood flow, were independent risk factors for symptomatic stenosis.Conclusion Collateral blood flow indownstream of intracranial arterial stenosis is the determinant of clinical symptoms.