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  本文關鍵詞： 磁共振成像 動脈自旋標記技術(shù) 缺血性腦血管病 腦梗死 短暫性腦缺血發(fā)作 腦血流量　出處：《山東大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:應用3.0T磁共振動脈自旋標記灌注技術(shù)(magnetic resonance perfusion imaging arterial spin labeling,MRI-ASL)對缺血性腦血管病進行掃描,對原始圖像采用Functool處理,將重建圖像與多種磁共振技術(shù)成像進行對照,探討磁共振動脈自旋標記灌注成像技術(shù)在缺血性腦血管病中的應用價值。材料與方法:128例2015年7月至2016年6月在本院接受磁共振檢查的腦血管病(ischemic cerebrovascular disease,ICVD)患者,其中腦梗死(cerebral infarction,CI)患者50例、短暫性腦缺血發(fā)作(transient ischemic attack,TIA)患者78例。所有患者均行磁共振常規(guī)掃描((T1WI、T2WI、T2-FLAIR)、磁共振彌散加權(quán)成像(diffusion weighted imaging,DWI))、磁共振血管成像(magnetic resonance angiography,MRA)和三維動脈自旋標記灌注成像(3D-ASL)。腦梗死患者組:測量ASL灌注異常面積和DWI信號異常面積,根據(jù)ASL灌注異常面積與DWI信號異常面積將患者分為ASLDWI組、ASL≈DWI組、ASLDWI組,研究分析患者ASL及DWI圖像;TIA患者組:對檢查結(jié)果分為MRA陽性+ASL陽性組、MRA陽性+ASL陰性組、MRA陰性+ASL陽性組、MRA陰性+ASL陰性組,統(tǒng)計分析各種檢查技術(shù)及聯(lián)合應用的臨床價值。結(jié)果:腦梗死組:ASL灌注異常面積與DWI信號異常面積經(jīng)配對t檢驗,差異有統(tǒng)計學意義(P0.01)。其中 ASLDWI 患者 47 例(47/50,94.0%),ASL≈DWI 患者 1 例(1/50,2.0%),ASLDWI 患者 2 例(2/50,4.0%)。TIA患者組:常規(guī)掃描及DWI顯示信號異常的0例(0%);MRA顯示血管異常的41例(52.6%);ASL顯示灌注異常的患者47例(60.2%);兩者聯(lián)合應用顯示異�；颊�60例(76.9%)。其中MRA陽性+ASL陽性的患者29例;MRA陽性+ASL陰性的患者12例;MRA陰性+ASL陽性的患者19例;MRA陰性+ASL陰性的患者18例。結(jié)論:結(jié)合患者臨床癥狀和隨訪結(jié)果,ASL在缺血性腦血管病的臨床診斷中有重要的意義,優(yōu)于磁共振常規(guī)序列且方便易行。結(jié)合DWI掃描,能夠確定腦梗死中半暗帶的范圍;可以提供短暫性腦缺血發(fā)作患者的血流灌注情況,與MRA、DWI聯(lián)合應用能顯著提高診斷準確率。應作為缺血性腦血管疾病的常規(guī)掃描序列。
[Abstract]:Objective: application of 3.0T arterial spin labeling magnetic resonance perfusion technique (magnetic resonance perfusion imaging arterial spin labeling, MRI-ASL) to scan the ischemic cerebrovascular disease, the original image is processed by Functool. The reconstructed image with various imaging magnetic resonance techniques were compared, to explore the application value of magnetic resonance perfusion imaging of arterial spin labeling in ischemic cerebrovascular disease. Materials and methods: 128 cases from July 2015 to June 2016 in cerebrovascular disease in our hospital for MRI (ischemic cerebrovascular disease ICVD (cerebral) in patients with cerebral infarction, including infarction, CI) in 50 patients with transient ischemic attack (transient ischemic, attack, TIA) 78 patients. All patients were underwent conventional MRI ((T1WI, T2WI, T2-FLAIR), diffusion weighted magnetic resonance imaging (diffusion weighted, imaging, DWI)), magnetic resonance angiography (magnetic resonance angiography, MRA) and 3D arterial spin labeling (3D-ASL) perfusion imaging in patients with cerebral infarction group. ASL: measurement of abnormal perfusion area and DWI abnormal signal area, according to the abnormal ASL perfusion area and DWI abnormal signal area were divided into ASLDWI group, ASL = DWI group, ASLDWI group, ASL and DWI were analyzed image; TIA group: the patients were divided into MRA positive +ASL positive group, MRA positive +ASL negative group, MRA negative and +ASL positive group, MRA negative and +ASL negative group, the clinical value of statistical analysis of various imaging techniques and combined application. Results: the cerebral infarction group: ASL perfusion area and DWI abnormal signal area by paired t test, the difference was statistically significant (P0.01). Among 47 cases of ASLDWI (47/50,94.0%), 1 cases of ASL patients (1/50,2.0% = DWI), 2 cases of patients with ASLDWI (2/50,4.0%).TIA group: conventional scan and DWI showed abnormal signal 0 Cases (0%); MRA showed 41 cases of vascular anomalies (52.6%); ASL showed 47 cases of abnormal perfusion of patients (60.2%); combination showed 60 cases with abnormal (76.9%). Among the 29 cases of MRA positive +ASL positive patients; 12 cases of MRA positive +ASL negative patients; 19 cases of MRA negative +ASL positive patients; 18 cases of patients with MRA +ASL negative. Conclusion: the combination of clinical symptoms and follow-up results of patients with ASL has important significance in clinical diagnosis of ischemic cerebrovascular disease, is better than conventional MR sequences and convenient. Combined with DWI scan, to determine the scope of the penumbra of cerebral infarction can provide; transient cerebral perfusion in patients with ischemic stroke, and MRA, DWI combined application can significantly improve the accuracy of diagnosis. As a routine scan sequence of ischemic cerebrovascular disease.

【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R445.2;R743

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