本文選題：腦血流量 + 后循環(huán)缺血��； 參考：《中國(guó)醫(yī)學(xué)科學(xué)院學(xué)報(bào)》2017年02期

【摘要】：目的探究三維準(zhǔn)連續(xù)動(dòng)脈自旋標(biāo)記灌注成像(3D-pCASL)對(duì)80歲以上老年人后循環(huán)缺血(PCI)的診斷價(jià)值,對(duì)老年人PCI的臨床診斷提供影像學(xué)依據(jù)。方法對(duì)80歲以上臨床診斷為PCI的老年男性患者20例以及正常老年男性33名分別進(jìn)行磁共振常規(guī)掃描及3D-pCASL掃描,延遲標(biāo)記時(shí)間(PLD)選取1525和2525 ms,利用SPM12軟件分別測(cè)量其左側(cè)枕葉、右側(cè)枕葉、左側(cè)小腦、右側(cè)小腦腦血流量(CBF)。采用獨(dú)立樣本t檢驗(yàn)及秩和檢驗(yàn)比較在兩個(gè)PLD時(shí)間病例組與對(duì)照組前后循環(huán)CBF的差異,病例組與對(duì)照組雙側(cè)枕葉、雙側(cè)小腦CBF的差異,以及病例組與對(duì)照組在兩個(gè)PLD時(shí)間的時(shí)間間隔中雙側(cè)枕葉、雙側(cè)小腦CBF增量(△CBF)的差異。結(jié)果病例組在PLD時(shí)間為1525 ms及2525 ms時(shí),前循環(huán)的CBF值均高于后循環(huán)CBF值,而對(duì)照組僅在1525 ms時(shí)前循環(huán)的CBF值均高于后循環(huán)CBF值,差異具有統(tǒng)計(jì)學(xué)意義(P=0.000,P=0.000,P=0.025);病例組在兩個(gè)PLD時(shí)間時(shí)雙側(cè)枕葉、雙側(cè)小腦的CBF值均低于對(duì)照組,差異均具有統(tǒng)計(jì)學(xué)意義(P=0.003,P=0.002,P=0.000,P=0.001,P=0.000,P=0.001,P=0.002,P=0.014);與對(duì)照組相比,病例組在兩個(gè)PLD時(shí)間的時(shí)間間隔中雙側(cè)枕葉、小腦△CBF均更小,差異均具有統(tǒng)計(jì)學(xué)意義(P=0.004,P=0.001,P=0.001,P=0.025)。結(jié)論高年齡段老年人因后循環(huán)血流慢,3D-pCASL技術(shù)需采用多個(gè)PLD時(shí)間判斷PCI的有無;3D-pCASL技術(shù)對(duì)檢測(cè)后循環(huán)CBF下降敏感,可作為老年人后循環(huán)卒中預(yù)警手段之一。
[Abstract]:Objective to investigate the diagnostic value of 3D quasi-continuous arterial spin-labeled perfusion imaging (3D-pCASL) for posterior circulation ischemia (PCI) in elderly patients over 80 years old, and to provide imaging basis for clinical diagnosis of PCI in elderly patients. Methods Twenty elderly men over 80 years old diagnosed as PCI and 33 normal elderly men were examined by conventional magnetic resonance imaging and 3D-pCASL respectively. 1525 and 2525 mswere selected for delayed labeling time. The left occipital lobe was measured by SPM12 software. Right occipital lobe, left cerebellum, right cerebellar blood flow (CBF). Independent sample t-test and rank sum test were used to compare the difference of circulating CBF between the two PLD time groups and control group, and the difference of CBF in both occipital lobes and cerebellum between case group and control group. The CBF increment (CBFs) of bilateral occipital lobe and cerebellum in the two PLD time intervals between the case group and the control group were also analyzed. Results when the PLD time was 1525 Ms and 2525 Ms, the CBF values of the anterior circulation were higher than those of the posterior circulation, while those of the control group were higher than those of the posterior circulation only at 1525 Ms. The CBF values of bilateral occipital lobes and cerebellum in the case group were all lower than those in the control group at the time of two PLD, and the differences were statistically significant (P 0.003, P 0.002 P0. 000 P0. 001P0. 000P0. 000P0. 001P0. 001P0. 002P0. 014). Compared with the control group, the bilateral occipital lobes were found in the two PLD time intervals. The CBF of cerebellum was smaller, and the difference was statistically significant (P = 0.004, P = 0.001, P = 0.001, P = 0.001, P = 0.025, P = 0.025). Conclusion the 3D-pCASL technique in elderly patients with high age needs to use multiple PLD time to judge whether PCI is available or not, which can be used as one of the early warning methods for post-circulatory stroke in the elderly.
【作者單位】： 中國(guó)人民解放軍總醫(yī)院南樓放射科 通用電氣(北京)醫(yī)療系統(tǒng)集團(tuán)磁共振事業(yè)部 北京大學(xué)磁共振成像研究中心
【分類號(hào)】：R445.2;R743.3

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本文編號(hào)：2014512