本文選題：動脈自旋標記 + 腦灌注��； 參考：《中國人民解放軍醫(yī)學(xué)院》2014年碩士論文

【摘要】：第一部分磁共振三維動脈自旋標記技術(shù)在正常成人腦部應(yīng)用的可重復(fù)性研究 目的:研究磁共振三維動脈自旋標記技術(shù)（there dimensional pseudo-continuousarterial spin labeling,3D ASL）應(yīng)用于正常成人全腦血流灌注成像的可重復(fù)性。材料與方法:對8例健康成年人進行腦部3D ASL序列及3D結(jié)構(gòu)像掃描，間隔一周后同一時間再次進行掃描，對兩次采集的ASL數(shù)據(jù)采用基于體素的組內(nèi)相關(guān)系數(shù)（intraclass correlation coefficient, ICC）分析。結(jié)果: ICC值為0.4-1的腦區(qū)主要位于雙側(cè)額葉及顳葉灰質(zhì)及白質(zhì)、雙側(cè)頂葉及枕葉白質(zhì)、雙側(cè)小腦半球及腦干。結(jié)論:3D ASL可重復(fù)性好，是一個可靠的評估腦灌注的序列。 第二部分磁共振三維動脈自旋標記技術(shù)在評價短暫性腦缺血發(fā)作患者腦血流灌注中的初步應(yīng)用 目的：探討磁共振三維動脈自旋標記技術(shù)（3D ASL）腦灌注成像在評價短暫性腦缺血發(fā)作（transient ischemic attack, TIA)患者腦血流灌注中的應(yīng)用價值。材料與方法：對18例TIA患者及22例健康志愿者進行常規(guī)MRI、腦結(jié)構(gòu)像掃描和3D ASL（PLD1525ms、2025ms、2525ms）全腦灌注成像。采用基于體素分析(voxel-basedanalysis,VBA)的方法對腦血流圖（cerebral blood flow,CBF）進行分析，評價不同PLD時間對腦灌注異常的檢出效能。結(jié)果：與健康對照（health control, HC）組比，TIA組患者存在CBF減低腦區(qū)。不同PLD（PLD1525ms、2025ms、2525ms）時間CBF減低區(qū)域數(shù)量及大小分別為18個激活簇（1390個體素）、24個激活簇（728個體素）及10個激活簇（73個體素）。 ROC曲線分析結(jié)果顯示PLD1525ms檢查方案的敏感性和特異性最高。結(jié)論：3D ASL全腦容積灌注成像技術(shù)能夠敏感檢出TIA患者腦部灌注異常改變，不同PLD時間對腦灌注異常的檢出有一定影響。 第三部分磁共振三維動脈自旋標記技術(shù)與動態(tài)磁敏感對比灌注成像在短暫性腦缺血發(fā)作中的對比研究 目的：對比研究磁共振三維動脈自旋標記技術(shù)（there dimensional pseudo-continuousarterial spin labeling,3D ASL）與動態(tài)磁敏感對比灌注成像（dynamic susceptibilitycontrast-perfusion weighted imaging，DSC-PWI)在評價短暫性腦缺血發(fā)作（transientischemic attack)中的應(yīng)用價值。材料與方法：對10例TIA患者進行常規(guī)MRI、腦結(jié)構(gòu)像掃描和3D ASL全腦灌注成像， PLD選擇1525ms、2025ms、2525ms，同時進行DSC灌注成像。視覺評定2種灌注技術(shù)的異常表現(xiàn)，并測量腦血流（cerebralblood flow, CBF）減低區(qū)域CBF值及對側(cè)正常鏡像區(qū)域CBF值，計算rCBF比值。結(jié)果:定性分析顯示10例患者中，2種技術(shù)檢查8例結(jié)果一致(灌注異常6例，正常灌注2例)，2例不一致，其中4例ASL顯示延遲灌注不足而DSC-PWI顯示正常。定量分析灌注異常區(qū)與對照側(cè)CBF/rCBF比值，經(jīng)配對資料的t檢驗，，兩種方法間差異無統(tǒng)計學(xué)意義(P0．05)。結(jié)論：3D ASL與DSC-PWI兩種灌注方法對判斷TIA患者的血流灌注情況具有一致性。3DASL可定量分析全腦血流灌注情況，作為一種無創(chuàng)的影像學(xué)檢查方法對TIA的血流動力學(xué)研究有重要價值。
[Abstract]:Part one: reproducibility of three-dimensional magnetic resonance spin labeling in normal adult brain.
Objective: To study the reproducibility of there dimensional pseudo-continuousarterial spin labeling (3D ASL) in normal adult whole brain perfusion imaging. Materials and methods: the brain 3D ASL sequence and 3D structural image scan were carried out in 8 healthy adults, and one week after the same time was reentered at the same time. The two ASL data were analyzed by intraclass correlation coefficient (ICC) based on voxel. Results: the brain region with ICC value of 0.4-1 was mainly located in the bilateral frontal lobe and temporal lobe gray matter and white matter, bilateral parietal lobe and occipital white matter, bilateral small hemisphere and brain stem. Conclusion: 3D ASL reproducibility is good, it is one A reliable evaluation of the sequence of cerebral perfusion.
The second part is the preliminary application of three-dimensional arterial spin labeling technique in evaluating cerebral blood perfusion in patients with transient ischemic attack.
Objective: To explore the value of 3D ASL perfusion imaging (3D ASL) in the evaluation of cerebral blood flow in patients with transient ischemic attack (transient ischemic attack, TIA). Materials and methods: 18 cases of TIA patients and 22 healthy volunteers were treated with conventional MRI, brain structure scan and 3D ASL (PLD1525ms, 2025m). S, 2525ms) whole brain perfusion imaging. The method of voxel-basedanalysis (VBA) was used to analyze the cerebral blood flow chart (cerebral blood flow, CBF) and evaluate the detection efficiency of different PLD time to cerebral perfusion abnormality. The 2025ms, 2525ms) time CBF reduction area and size were 18 activation clusters (1390 individual elements), 24 activation clusters (728 individual elements) and 10 activation clusters (73 individual elements). The ROC curve analysis showed that the sensitivity and specificity of the PLD1525ms examination scheme were the highest. Conclusion: 3D ASL whole brain perfusion imaging technique can be sensitive to the detection of TIA patients. Abnormal brain perfusion changes, and different PLD time had a certain effect on the detection of cerebral perfusion abnormalities.
The third part is a comparative study of three dimensional arterial spin labeling technique and dynamic susceptibility contrast perfusion imaging in transient ischemic attack.
Objective: To compare the evaluation of there dimensional pseudo-continuousarterial spin labeling (3D ASL) and dynamic magnetic susceptibility contrast perfusion imaging (dynamic susceptibilitycontrast-perfusion weighted imaging, DSC-PWI) in the evaluation of short temporary ischemic attacks. Value. Materials and methods: 10 patients with TIA were performed routine MRI, brain structure scan and 3D ASL perfusion imaging, PLD selected 1525ms, 2025ms, 2525ms, and DSC perfusion imaging. The abnormal manifestations of the 2 perfusion techniques were evaluated by vision, and the regional cerebral blood flow (cerebralblood flow, CBF) decreased and the contralateral normal image region was measured. BF value and calculated the ratio of rCBF. Results: of the qualitative analysis, 2 of the 10 patients showed the same results in 8 cases (6 cases of perfusion abnormality, 2 cases of normal perfusion) and 2 cases, of which 4 cases of ASL showed delayed perfusion and DSC-PWI showed normal. Quantitative analysis of abnormal perfusion area and CBF/rCBF ratio, t test of paired data, two methods There is no statistical significance (P0.05). Conclusion: the two perfusion methods of 3D ASL and DSC-PWI have a consistent.3DASL to determine the blood flow perfusion in TIA patients. As a noninvasive method of imaging examination, it is of great value to study the hemodynamic study of TIA.

【學(xué)位授予單位】：中國人民解放軍醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R445.2;R743.31

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