【摘要】 目的 比较动脉自旋标记（ASL）与CT灌注成像（CTP）技术监测颈动脉内膜切除术（CEA）患者手术前后脑血流量（CBF）的一致性，并优化手术前、后ASL采用的标记后延迟时间（PLD）。方法 24例因颈动脉狭窄行CEA的患者分别于术前2周、术后1周内行2组不同PLD的ASL[ASL_1.5（PLD=1.5 s）和ASL_2.0（PLD=2.0 s）]和CTP检查，获得CBF图像并测量CBF值。统计分析ASL_1.5、ASL_2.0与CTP测得的术前相对脑血流量（rCBF）、术后rCBF和术侧CBF变化率(DR_CBF)之间的一致性。结果 ASL和CTP对于测量术前、术后rCBF和DR_CBF具有强相关性（r=0.67～0.85,P<0.01）。以CTP为对照，ASL_2.0测得的术前rCBF比ASL_1.5具有更小的偏倚（-0.02 vs-0.07）,ASL_2.0和ASL_1.5测得的术后rCBF具有相同的偏倚（0.03）。对于测量DR_CBF,手术前后PLD均为2.0 s(ASL_2.0＿2.0)和术前PLD为2.0 s、术后PLD为1.5 s(ASL_2.0＿1.5)的偏倚（0.31 vs 0.32）相似且均小于手术前后PLD均为1.5 s(ASL_1.5＿1.5)和术前PLD为1.5 s、术后PLD为2.0 s(ASL_1.5＿2.0)的偏倚（均为0.60）。结论 ASL和CTP对于评估CEA手术前、后rCBF具有较好的一致性；然而ASL较CTP会显著高估CEA术后的DR_CBF。CEA术前ASL更为合适的PLD为2.0 s,而CEA术后可选择1.5 s或2.0 s。更多还原

【Abstract】 Objective To compare the consistency between arterial spin labeling（ASL） and computed tomography perfusion（CTP） in measuring the cerebral blood flow（CBF） of patients who underwent carotid endarterectomy（CEA）,and to optimize the post labeling delay（PLD） of ASL for pre-and post-operative perfusion imaging.Methods A total of 24 patients who scheduled for CEA due to carotid stenosis were included in this study.ASL with two PLD（1.5 s and 2.0 s） and CTP were performed 2 weeks before and 1 week after CEA respectively to obtain the CBF maps and measure CBF values.The consistencies in measuring pre-and post-operative relative cerebral blood flow（rCBF） and difference ratio of CBF(DR_CBF) on the operation side between ASL with PLD of 1.5 s(ASL_1.5) or 2.0s(aSL_2.0) and CTP were also determined.Results There was strong correlation in measuring pre-and post-operative rCBF and DR_CBF between ASL and CTP（r=0.67-0.85,P<0.01）.Using CTP as the reference standard,smaller bias could be achieved in measuring rCBF by ASL_2.0（-0.02） than ASL_1.5（-0.07） before CEA.In addition,same bias（0.03） was obtained by ASL_2.0 and ASL_1.5 after CEA.The bias of ASL_2.02.0（0.31） and ASI_2.01.5（0.32） on DR_CBF measurement were similar and both were smaller than that of ASL_1.51.5（0.60） and ASL_1.52.0（0.60）.Conclusion ASL and CTP have relatively good consistency in assessing pre-and post-operative rCBF;however,compared with CTP,ASL may significantly overestimate DR_CBF.During perioperative ASL,the PLD of2.0 s is better than 1.5 s for preoperative scan and both 1.5 s and 2.0 s are suitable for postoperative scan.更多还原