摘要
目的探究功能磁共振三维伪连续动脉自旋标记(3D-ASL)和磁共振弥散加权成像(DWI)模式对缺血性脑卒中患者颅内血流动力学及梗死情况的应用价值。方法选取2018年4月至2019年9月我院影像科诊治的80例疑似缺血性脑卒中患者进行研究。同期体健康者32例作为对照组。均进行数字减影血管造影检查、3D-ASL及DWI检查,评估3D-ASL联合DWI模式诊断价值。结果DWI模式诊断缺血性脑卒中总准确率为86.25%,其结果与数字减影血管造影检查Kappa值为0.678,P<0.001。3D-ASL诊断缺血性脑卒中总准确率为90.00%,其结果与数字减影血管造影检查Kappa值为0.763,P<0.001。两种模式联合诊断缺血性脑卒中总准确率为91.25%,其结果与数字减影血管造影检查Kappa值为0.789,P<0.001;两者联合诊断缺血性脑卒中与病理检查一致性优于单纯的DWI模式和3D-ASL模式。58例DWI模式呈高信号的3D-ASL患者,存在灌注异常。33例诊断为右侧缺血性脑卒中,右侧CBF绝对值低于左侧,且两侧均低于对照组,差异显著(P<0.05);25例诊断为左侧缺血性脑卒中,右侧CBF绝对值高于左侧,且两侧均低于对照组,差异显著(P<0.05)。结论功能磁共振ASL和DWI模式对缺血性脑卒中患者诊断准确率较高,且ASL模式可有效观察对缺血性脑卒中患者颅内梗死病灶血流动力学情况,结合DWI模式可有效观察颅内缺血梗死灌注情况。
Objective To explore the application value of three-dimensional pseudo-continuous arterial spin labeling(3D-ASL)and magnetic resonance imaging diffusion weighted imaging(DWI)modes in patients with ischemic stroke.Methods A total of 80 patients with suspected ischemic stroke diagnosed and treated in the imaging department of our hospital from April 2018 to September 2019 were enrolled,and 32 healthy individuals were used as the control group.Digital subtraction angiography,3D-ASL,and DWI were performed in all cases,and the diagnostic value of 3D-ASL combined with DWI was evaluated.Results The total accuracy of DWI diagnosis of ischemic stroke was 86.25%,and the Kappa value of the results and digital subtraction angiography was 0.678,P<0.001.The total accuracy of 3D-ASL in the diagnosis of ischemic stroke was 90.00%,and the Kappa value of the results and digital subtraction angiography was 0.763,P<0.001.The total accuracy of the two modes in the diagnosis of ischemic stroke was 91.5%,and the Kappa value of the results and the digital subtraction angiography examination was 0.789,P<0.001.The agreement of the two modes in the diagnosis of ischemic stroke and pathological examination was better than that of DWI and 3D-ASL alone.Fifty-eight patients with 3D-ASL in high signal for DWI pattern had abnormal perfusion,of which 33 cases were diagnosed with right ischemic stroke,the absolute value of CBF on the right lower than that on the left,and both sides lower than the control group(P<0.05);And of which 25 cases were diagnosed with left ischemic stroke,the absolute value of CBF on the right higher than that on the left,and both sides lower than the control groupt(P<0.05).Conclusions Functional MRI ASL and DWI modes have higher diagnostic accuracy in patients with ischemic stroke,where ASL mode can effectively present the hemodynamics of intracranial infarction lesions and can effectively present Intracranial ischemic infarction perfusion with DWI mode.
作者
张亚运
李珍
苗重昌
ZHANG Ya-yun;LI Zhen;MIAO Chong-chang(Department of Imaging,the First People's Hospital of Lianyungang,Lianyungang 222000,Jiangsu Province,China;Department of Imaging,Lianyungang Traditional Chinese Medicine Hospital,Lianyungang 222001,Jiangsu Province,China)
出处
《中国CT和MRI杂志》
2022年第6期32-35,共4页
Chinese Journal of CT and MRI
关键词
磁共振ASL
磁共振DWI
缺血性脑卒中
颅内
血流动力学
梗死
Magnetic Resonance Imaging ASL
Magnetic Resonance Imaging DWI
Ischemic Stroke
Intracranial
Hemodynamics
Infarction
