【摘要】 目的 对比研究动脉血质子自旋标记(arterial spin labeling,ASL)与动态磁敏感对比成像(dynamic susceptibility contrast,DSC)在大脑中动脉供血区脑卒中溶栓治疗中的应用价值。方法 67例发病12 h内的急性脑卒中患者,除常规MRI检查外,在DWI确认为大脑中动脉缺血区脑梗死者,采用GE 1.5TMR进行脉冲式ASL和DSC检查,并分别用2种灌注技术与DWI结合来判断缺血半暗带,2种方法判断结果采用Kappa一致性检验。结果 定性分析显示67例患者中61例2种技术检验结果一致,6例2种技术检验结果不一致,Kappa>0.75(K=0.820 9),两者一致性较好。定量分析示,2种技术的病侧与对照侧信号强度比值ASL为0.70±0.44,DSC为0.71±0.41,两者间差异无统计学意义(P>0.05)。结论 无创性ASL技术检测灌注异常时与DSC技术有相似的敏感性;ASL可作为一项DSC的替代技术用于指导大脑中动脉供血区脑卒中溶栓治疗。更多还原

【Abstract】 Objective To compare the application value of proton spin labeling arterial blood(arterial spin labeling,ASL) and dynamic susceptibility contrast imaging(dynamic susceptibility contrast,DSC) in the middle cerebral artery area stroke thrombolytic therapy.Methods 67 patients within 12 hours of onset of acute stroke were presented.In addition to routine MRI scanning,GE 1.5T MR pulsed ASL and DSC examinations were applied on the subjects with the ischemic area of middle cerebral artery infarction according to the DWI findings,and both methods,combined with DWI,were used to determine the ischemic penumbra.the results of two methods were analyzed by Kappa test.Results The results of qualitative analysis turned out that the results of 61 cases showed consistance between two methods while the other 2 cases were not,Kappa> 0.75(K=0.8209),which revealed good concordance.Quantitative analysis indicated that the ASL and DSC signal intensity ratio of patients to controls were 0.70±0.44 and 0.71±0.41 respectively,which showed no significant difference(P>0.05).Conclusion The noninvasive ASL had a parallel sensitivity to DSC when detecting perfusion abnormalities,thus ASL can be used as an alternative technology guiding the middle cerebral artery area stroke thrombolysis.更多还原