本文選題：腦梗死 + 亞急性期�。� 參考：《浙江大學(xué)》2017年碩士論文

【摘要】：研究目的探討基于體素內(nèi)不相干運(yùn)動(introvoxel incoherent motion,IVIM)的亞急性期腦梗死病灶內(nèi)微結(jié)構(gòu)和微循環(huán)的改變,并初步探究IVIM參數(shù)值和臨床轉(zhuǎn)歸的關(guān)系。研究方法納入25例起病第3-7天、未進(jìn)行溶栓治療的大腦中動脈供血區(qū)域腦梗死患者,進(jìn)行彌散加權(quán)成像(diffusion-weighted imaging,DWI)及IVIM掃描,記錄入院基線 NHISS(NationalInstitute of Health stroke scale)評分,并且以 3 個(gè)月后 mRS(modified Rankin Scale)評分2分定義為預(yù)后較差。依據(jù)表觀彌散系數(shù)(apparent diffusion coefficient,ADC)值將病灶分為不同感興趣區(qū)(region ofinterest,ROI),包括核心梗死區(qū)(ADC≤0.55×10-3 mm2/s)和核心周圍區(qū)(ADC0.55×10-3 mm2/s),再分別得到這些ROI的體積、ADC值和IVIM各參數(shù)值。IVIM經(jīng)過圖像處理后得到的參數(shù):慢彌散系數(shù)(slow diffusion coefficient,D)、快彌散系數(shù)(fast diffusion coefficient,D*)和灌注分?jǐn)?shù)(perfusion fraction,f)。校正 ADC(rADC)值定義為核心梗死區(qū)ADC值與對側(cè)ADC值的比值,同理可得病灶內(nèi)核心梗死區(qū)和核心周圍區(qū)的各rADC值、rD值、rD*值和rf值。采用配對T檢驗(yàn)和Pearson相關(guān)分析比較各ROI影像學(xué)參數(shù)存在的差異及關(guān)系。進(jìn)一步分析IVIM各參數(shù)分別和入院NIHSS評分、3月后隨訪mRS評分的相關(guān)性。研究結(jié)果(1)病灶內(nèi)ADC、D和f值均較對側(cè)下降(P0.05)。(2)核心周圍區(qū)rADC,rD和rf值較核心梗死區(qū)明顯降低(P0.001)。(3)在核心梗死區(qū)rADC和rD呈負(fù)相關(guān)(P=0.004),在核心周圍區(qū) rADC 和 rD(P=0.01)、rADC 和 rf(P=0.029)均呈負(fù)相關(guān)。(4)核心梗死區(qū)的rD值分別和NIHSS評分、3月后mRS評分呈負(fù)相關(guān)。研究結(jié)論核心周圍區(qū)較核心梗死區(qū)D和f值增高,提示腦梗死亞急性期核心周圍區(qū)病理生理的代償,微結(jié)構(gòu)和微循環(huán)代償可能。D值能為腦梗死的臨床預(yù)后評價(jià)提供信息。
[Abstract]:Objective to investigate the changes of microstructures and microcirculation in subacute cerebral infarction lesions based on intra voxel incoherent motionIVIMA, and to explore the relationship between IVIM parameters and clinical outcome. Methods Twenty-five patients with cerebral infarction in the middle cerebral artery supplying region without thrombolytic therapy were enrolled in the study. Diffusion weighted imaging imaging (DWI) and IVIM scan were performed to record the baseline NHISS(NationalInstitute of Health stroke scale score. And the mRS(modified Rankin scale score of 2 was defined as poor prognosis 3 months later. According to the apparent diffusion coefficient diffusion diffusion coefficient, the lesions are divided into different regions of interest, including ADCs 鈮，

本文編號：1777909