本文選題：磁共振成像 + 動脈自旋標(biāo)記　； 參考：《蘇州大學(xué)》2014年碩士論文

【摘要】：1目的 對照研究動脈質(zhì)子自旋標(biāo)記（arterial spin labeling，ASL）與動態(tài)磁敏感對比增強MRI (dynamic susceptibility contrast-enhanced MRI，DSC-MRI)在評價腦卒中缺血半暗帶中的應(yīng)用價值。 2材料與方法 對34例發(fā)病12h內(nèi)的急性腦卒中患者行常規(guī)MRI、擴散加權(quán)成像（DWI）、ASL和DSC檢查。ASL檢查方法采用單、多相位技術(shù)進行掃描，單相位ASL反轉(zhuǎn)時間TI=1800ms；多相位ASL，相位數(shù)為8，每個相位之間相差300ms（TI=300ms，600ms，900ms，1200ms，1500ms，1800ms，2100ms，2400ms）。DSC采用平面回波-自由衰減（EPI-FID）序列，采集40次，，在第4次掃描時利用高壓注射器快速團注釓噴酸葡胺Gd-DTPA0.2mmol/kg，流率為5mL/s。觀察2種技術(shù)的灌注特點，包括低灌注、高灌注、正常灌注、是否伴有局部高灌注。 采用SPSS17.0軟件進行統(tǒng)計學(xué)分析。分別將2種灌注技術(shù)與DWI結(jié)合來評價缺血半暗帶（ischemic penumbra，IP），2種灌注技術(shù)評價結(jié)果采用Mann-Whitney(曼-惠特尼)U檢驗做定性分析；以DWI顯示的最大病變?yōu)闃?biāo)準(zhǔn)層面，分別測量2種技術(shù)異常灌注范圍大小，結(jié)果采用獨立樣本t檢驗做定量分析。 3結(jié)果 定性分析，34例患者中32例2種灌注方法判斷結(jié)果一致（低灌注30例，其中存在IP17例，不存在IP13例；高灌注2例），兩者間差異無統(tǒng)計學(xué)意義（Z=-0.054，P0.05）。 定量分析，34例患者2種灌注技術(shù)顯示的最大病變層面異常灌注區(qū)面積大小，SDSC=27.1714.07cm2，SASL=29.1012.72cm2，兩者間差異無統(tǒng)計學(xué)意義（t=-0.499，P0.05）。 2例2種技術(shù)灌注結(jié)果不一致（2例ASL均表現(xiàn)為高灌注，DSC均為正常灌注）；6例患者ASL圖顯示低灌注區(qū)伴局部高灌注，占整個低灌注患者的20%（6/30），而DSC不存在此表現(xiàn)。 4結(jié)論 4.1無創(chuàng)性ASL技術(shù)與DSC技術(shù)對評價腦卒中IP具有較好的一致性。 4.2ASL對顯示腦卒中高灌注、低灌注區(qū)伴局部高灌注（提示側(cè)枝循環(huán)存在）可能比DSC更敏感。
[Abstract]:1 purpose To evaluate the value of proton spin-labeled arterial spin labeling (ASL) and dynamic susceptibility contrast-enhanced MRII-DSC-MRI in evaluating ischemic penumbra in stroke. 2 Materials and methods Thirty-four patients with acute stroke within 12 hours after onset were examined by conventional MRI, diffusion weighted imaging (DWI) ASL and DSC. The inversion time of single phase ASL was 1800ms, the phase number of multi-phase ASL was 8, and the difference between each phase was 300ms / t 600ms / 600ms / 100ms / 100ms / 1500ms / 1 500ms / 1. DSCA was collected 40 times by plane echo / free attenuation EPI-FID.Gd-DTPA 0.2mmolkgkg was injected with a high pressure injector at the fourth scanning time, and the flow rate was 5mLrs / kg. The flow rate was 5mLrs-1 / kgGd-DTPA 0.2mmolkg-1 路kgGd-DTPA 0.2mmol / kg, and the flow rate was 5mLrs-1 / kg, using planar echo / free attenuating EPI-FIDS sequence. The perfusion characteristics of the two techniques were observed, including low perfusion, high perfusion, normal perfusion and local hyperperfusion. SPSS17.0 software was used for statistical analysis. Two perfusion techniques were combined with DWI to evaluate the results of two perfusion techniques in ischemic penumbra. Mann-Whitney (Mann-Whitney U test) was used for qualitative analysis, and the maximum lesion displayed by DWI was taken as the standard level. The range of abnormal perfusion of the two techniques was measured, and the results were quantitatively analyzed by independent t-test. 3 results The qualitative analysis showed that 32 cases of 34 patients had the same results by two perfusion methods (30 cases of low perfusion, including 30 cases of IP17, no case of IP13, and 2 cases of hyperperfusion, the difference was not statistically significant (P 0.05). Quantitative analysis showed that the area of abnormal perfusion area at the maximum lesion level was 27.1714.07cm ~ (2) and (29.1012.72) cm ~ (2). There was no significant difference between the two methods. There was no significant difference between the two groups (P _ (0.05). The results of two different perfusion techniques were inconsistent in 2 cases. All of the 2 cases of ASL showed that the hyperperfusion was normal in 6 cases. The ASL of 6 cases showed low perfusion area with local hyperperfusion, accounting for 20% 30% of the total hypoperfusion patients, but DSC did not. 4 conclusion 4.1 Non-invasive ASL and DSC techniques are consistent in assessing stroke IP. 4.2ASL may be more sensitive than DSC in showing stroke hyperperfusion, low perfusion with local hyperperfusion (indicating the presence of collateral circulation).
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R445.2;R743.3

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