| 周芯羽,董万利,张永刚,徐丙超,顾 艳.脑磁共振灌注成像在大脑中动脉狭窄与闭塞患者中的应用价值分析[J].,2021,(6):1055-1058 |
| 脑磁共振灌注成像在大脑中动脉狭窄与闭塞患者中的应用价值分析 |
| Analysis of the Application Value of Perfusion-weighted Imaging in Patients with Middle Cerebral Artery Stenosis and Occlusion |
| 投稿时间：2020-07-23 修订日期：2020-08-18 |
| DOI：10.13241/j.cnki.pmb.2021.06.012 |
| 中文关键词: 大脑中动脉 脑磁共振灌注成像 狭窄 闭塞 应用价值 |
| 英文关键词: Middle cerebral artery Perfusion-weighted imaging Stenosis Occlusion Application value |
| 基金项目:江苏省卫生计生委医学科研课题面上项目（H20161174）； 南京医科大学康达学院科研发展基金（KD2017KYJJZD016） |
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| 中文摘要: |
| 摘要 目的：研究脑磁共振灌注成像（PWI）在大脑中动脉（MCA）狭窄与闭塞患者中的应用价值。方法：纳入我院从2017年5月～2019年3月收治的单侧MCA狭窄与闭塞患者80例，对所有患者均实施经颅内数字减影血管造影（DSA）以及PWI检查，并将所有患者按照狭窄程度的不同分成轻度/中度组与重度/闭塞组。分析两组患者患侧与健侧大脑半球PWI相关参数，并作相关性分析。此外，分析PWI检查MCA狭窄或闭塞所致脑梗死类型分布情况。结果：DSA诊断结果显示：MCA轻度/中度狭窄患者35例，MCA重度/闭塞患者45例，其中MCA重度/闭塞的PWI检出率为100.00%，显著高于MCA轻度/中度狭窄的80.00%（P＜0.05）。MCA轻度/中度组、重度/闭塞组患者患侧大脑半球的平均通过时间（rMTT）、达峰时间（rTTP）均显著高于健侧（均P＜0.05）。经Spearman相关性分析可得：MCA患者狭窄程度与患侧大脑半球rMTT、rTTP均呈正相关关系（均P＜0.05）。PWI检查结果显示，80例患者共检查出脑梗死患者53例，其中重度/闭塞组脑梗死总检出率以及纹状体内囊区脑梗死检出率分别为82.22%、11.11%，均明显高于轻度/中度组的45.71%、0.00%（均P＜0.05）。结论：PWI应用于MCA狭窄与闭塞患者中的价值较高，可作为临床诊断MCA狭窄与闭塞的有效手段之一，值得临床推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To study the value of perfusion-weighted imaging (PWI) in patients with middle cerebral artery (MCA) stenosis and occlusion. Methods: 80 patients with unilateral MCA stenosis or occlusion who were admitted to our hospital from May 2017 to March 2019 were included in the study. All patients were examined by intracranial digital subtraction angiography (DSA) and PWI, and they were divided into mild/moderate group and severe/occlusive group according to the degree of stenosis. PWI parameters in the affected and healthy cerebral hemispheres of the two groups were analyzed, and the correlation was analyzed. In addition, the distribution of types of cerebral infarction caused by MCA stenosis or occlusion was analyzed. Results: DSA diagnosis showed that 35 patients with mild/moderate MCA stenosis, and 45 patients with severe/occlusive MCA stenosis, among which the detection rate of severe/occlusive MCA stenosis of PWI was 100.00%, which was significantly higher than that of 80.00% of mild/moderate MCA stenosis (P<0.05). The mean transit time (rMTT) and time to peak (rTTP) of MCA patients in the mild/moderate group and the severe/occluder group were significantly higher than those in the healthy side (all P<0.05). Spearson correlation analysis showed that the stenosis degree of MCA patients were positively correlated with rMTT and rTTP in the affected cerebral hemisphere (all P<0.05). PWI showed that there were 53 patients with cerebral infarction in 80 patients, among which the total cerebral infarction detection rate in the severe/occlusive group and the cerebral infarction detection rate in the striatum internal capsule area were 82.22% and 11.11%, respectively, which were significantly higher than the 45.71% and 0.00% in the mild/moderate group (all P<0.05). Conclusion: PWI is of high value in patients with MCA stenosis and occlusion, and it can be used as an effective means of clinical diagnosis of MCA stenosis and occlusion. It is worthy of clinical application. |
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