【摘要】 目的探讨急性缺血性脑卒中临床诊断中磁共振三维假连续式动脉自旋标记(3D-pcASL)成像技术的应用及临床价值。方法选取我院2019年2月至2020年1月收治的32例急性缺血性脑卒中患者作为研究对象。患者均行MRI、DWI及3D-pcASL检查,并测量溶栓治疗前、后半暗带区脑血流量(CBF)。结果治疗前,32例急性缺血性脑卒中患者DWI、3D-pcASL图像分别显示为高信号和低灌注;32例患者3D-pcASL图像的低灌注区域范围明显大于DWI图像。治疗后,30例患者梗塞区呈高灌注改变,CBF值明显增大,周围半暗带出现匍匐走行的条、团块状高灌注信号;半暗带ROI的CBF值为(63.99±8.69)mL/(100 g·min),明显高于治疗前的(13.84±1.62)mL/(100 g·min)(P<0.05)。1例异常特高灌注患者为卒中后出血改变;1例患者治疗前、后均呈低灌注区,面积和CBF值无明显改变。结论 3D-pcASL成像技术是一种安全无创的脑血流检查技术,有利于及时指导急性缺血性脑卒中患者的治疗并判断预后,其客观影像信息对临床精准治疗具有显著价值。更多还原

【Abstract】 Objective To investigate the application and clinical value of magnetic resonance three dimensional pseudocontinuous arterial spin labeling(3D-pcASL) imaging technology in clinical diagnosis of acute ischemic stroke.Methods A total of 32 patients with acute ischemic stroke treated in our hospital from February 2019 to January 2020 were selected as the research objects.All patients who underwent MRI, DWI and 3D-pcASL examinations, and the cerebral blood flow(CBF) in the penumbra before and after thrombolytic therapy were measured.Results Before treatment, DWI and 3D-pcASL images of 32 patients with acute ischemic stroke showed high signal and low perfusion respectively; the area of low perfusion in 3D-pcASL images of 32 patients was significantly larger than that of DWI images.After treatment, 30 patients showed high perfusion changes in the infarct area, CBF value increased significantly,and the surrounding penumbra showed creeping and strip and mass high perfusion signals; CBF value of penumbra ROI was(63.99 ± 8.69) mL/(100 g·min), which was significantly higher than(13.84 ± 1.62) mL/(100 g·min) before treatment(P <0.05).One patient with abnormal extra high perfusion had bleeding changes after stroke and one patient showed low perfusion area before and after treatment, and the area and CBF value had no significant change.Conclusion 3D-pcASL imaging technology is a safe and non-invasive cerebral blood flow examination technology, which is helpful to promptly guide the treatment of patients with acute ischemic stroke and judge the prognosis.Its objective image information has significant value for clinical precision treatment.更多还原