DSC-PWI在缺血性脑血管病中的应用价值

Yanping Jing, B. Luo, Zhengrong Gao, Xinfeng Xu, Li Yao, T. Cheng, Yan Zhang, Jingliang Cheng
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摘要

目的探讨动态敏感性增强灌注加权成像(DSC-PWI)在缺血性脑血管病(ICVD)脑血流灌注状况中的应用价值。方法回顾性分析31例ICVD患者的头颅磁共振(MRI)、弥散加权成像(DWI)、磁共振血管造影(MRA)及DSC-PWI临床诊断的影像资料,选择性分析相对脑血流量(rCBF)、相对脑血容量(rCBV)、平均传输时间(MTT)、峰值时间(TTP)等参数,总结其特点。结果ICVD 31例,灌注不足16例,rCBF明显降低,rCBV降低,MTT和TTP延长,其中大血管病变7例,小血管病变5例。侧支循环形成9例,其中代偿性好、rCBF正常、rCBV正常、MTT、TTP延长3例,代偿性差、rCBF减少、rCBV正常或增加、MTT、TTP延长6例。3例患者血液再灌注rCBF正常或轻度升高,rCBV升高,MTT缩短或正常,TTP缩短。3例过度灌注患者rCBF显著增高,rCBV显著增高,MTT、TTP缩短。结论DSC-PWI能可靠地反映ICVD灌注状态及侧支循环代偿情况,可指导临床治疗方案的选择,显著改善患者预后。关键词:缺氧缺血;脑;磁共振成像;动态敏感性对比增强灌注加权成像
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Application value of DSC-PWI in ischemic cerebrovascular disease
Objective To explore the application value in cerebral blood perfusion status of dynamic susceptibility contrast enhanced perfusion weighted imaging (DSC-PWI) in ischemic cerebrovascular disease (ICVD). Methods Retrospective analysis of 31 cases ICVD head magnetic resonance imaging (MRI), diffusion weighted imaging (DWI), magnetic resonance angiography (MRA) and DSC-PWI image in clinical diagnosis, and selectively analyze parameters including relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), mean transit time (MTT) and time to peak (TTP) for generalize its characteristics. Results 31 cases of ICVD, 16 cases hypoperfusion, rCBF decreased significantly, rCBV decreased, MTT and TTP prolonged, include 7 cases of large vessel disease and 5 cases of small vessel disease. The collateral circulation formed 9 cases, including 3 cases with good compensation, rCBF normal, rCBV normal, MTT and TTP prolonged, 6 cases with bad compensation, rCBF decreased, rCBV normal or increased, MTT and TTP prolonged. The blood reperfusion in 3 cases, rCBF normal or slightly increased, rCBV increased, MTT shortened or normal, and TTP shortened. The excessive perfusion in 3 cases, rCBF significantly increased and rCBV significantly increased, with MTT and TTP shortened. Conclusions DSC-PWI can reliably reflect the perfusion state and collateral circulation compensation of ICVD, so as to guide the selection of clinical treatment program and significantly improve the prognosis of patients. Key words: Hypoxia-ischemia, brain; Magnetic resonance imaging; Dynamic susceptibility contrast enhanced perfusion weighted imaging
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中国医师杂志
中国医师杂志 Medicine-Medicine (all)
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