【摘要】：目的：研究煙霧病患者病損區(qū)域局部血流動力學情況，探討磁共振腦灌注成像對煙霧病患者的臨床應用價值。 方法：收集5例我科近1年收治的，均經DSA檢查明確診斷為MMD的患者且全部為單側MMD患者。所有患者入院后經頭CTA初步檢查后進一步行PWI檢查，最終經DSA檢查明確診斷。磁共振PWI的檢查使用的是自由衰減EPI序列，檢查具體部位和范圍與T2加權相同，需不斷掃描五十次，當進行第六次掃描時靜脈推注順磁性對比劑（通常為Gd-DTPA），注射須使用高壓注射器，成人使用劑量約為0.2mmol/kg，推藥速率控制在3-5ml/s之內，注射完畢后以相同的劑量和速率推注生理鹽水。將所有掃描結果發(fā)送到專門的計算機進行分析，得出時間-強度相關關系，最后可得到各個腦血流灌注參數(shù)圖。選擇一個能最大顯示病變區(qū)域的層面，并在圖中標記出灌注異常區(qū)域，以對側為相對正常參考，測量出雙側大腦半球的灌注參數(shù)值。獲得的全部腦灌注參數(shù)值需經過標準化，該研究采用小腦作為參照。全部數(shù)據經SPSS11.0軟件處理，對患側與健側大腦對應供血區(qū)rTTP、rMTT、rCBF、rCBV值進行配對t檢驗，P 0.05為差異有顯著性意義。 結果：5例MMD患者的磁共振腦灌注成像均不正常，，患側各項腦灌注參數(shù)出現(xiàn)異常,結果顯示其最大峰值時間、平均通過時間延遲顯著,而局部腦血流量出現(xiàn)了明顯下降。所有患者病變側rCBV平均值為1.13±0.28，與健側（1.25±0.36）比較有顯著性差異(P 0.01)；病變側rCBF為1.11±0.36，與健側（1.32±0.40）比較有顯著性差異(P 0.01)。 結論：磁共振腦灌注成像能夠準確顯示MMD患者腦血流動力學情況，從而顯示其腦缺血程度及范圍；對MMD圍手術期患者血管條件及灌注區(qū)域進行術前評估、術后預測有重要意義。
[Abstract]:Objective: to study the regional hemodynamics of patients with moyamoya disease and to evaluate the clinical value of magnetic resonance cerebral perfusion imaging in patients with moyamoya disease. Methods: five patients with MMD diagnosed by DSA were collected and all of them were unilateral MMD patients. After admission, all patients were examined by PWI after initial CTA examination, and finally diagnosed by DSA. Magnetic resonance PWI (MRI) uses a free attenuated EPI sequence, which is the same location and range as T2 weighted and requires continuous scanning 50 times. Paramagnetism contrast agent (usually Gd-DTPA) is injected intravenously on the sixth scan. High pressure syringe should be used for injection. the dose of adult injection is about 0.2 mmol 路kg ~ (- 1), and the injection rate is controlled within 3-5ml/s. Normal saline is injected at the same dose and rate after injection. All the scanning results were sent to a special computer for analysis, and the time-intensity correlation was obtained. finally, the perfusion parameters of each cerebral blood flow were obtained. A plane with maximum display of lesion area was selected, and the abnormal perfusion area was marked in the diagram, and the perfusion parameters of bilateral cerebral hemispheres were measured with the contralateral side as a relatively normal reference. All the parameters of cerebral perfusion need to be standardized, and cerebellum is used as a reference in this study. All the data were processed by SPSS11.0 software, and the rTTP,rMTT,rCBF, rCBV values of the corresponding blood supply area between the affected side and the healthy side were tested by pairing t test, and there was significant difference between the two sides. Results: magnetic resonance cerebral perfusion imaging was abnormal in 5 patients with MMD. The parameters of cerebral perfusion on the affected side were abnormal. The results showed that the maximum peak time, the average transit time and the local cerebral blood flow were significantly delayed, while the regional cerebral blood flow was significantly decreased. The average rCBV of the lesion side was 1.13 鹵0.28, which was significantly different from that of the healthy side (1.25 鹵0.36). The rCBF of the lesion side was 1.11 鹵0.36, which was significantly different from that of the healthy side (1.32 鹵0.40). Conclusion: magnetic resonance cerebral perfusion imaging can accurately display the cerebral hemodynamics of patients with MMD, thus showing the degree and extent of cerebral ischemia, and it is of great significance to evaluate the vascular conditions and perfusion area of patients in perioperative period of MMD before operation.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R743;R445.2

【參考文獻】

相關期刊論文 前2條

1 盧潔;李坤成;;MR灌注成像在頸內動脈和大腦中動脈狹窄與閉塞的應用研究[J];臨床放射學雜志;2006年02期

2 高培毅;;腦梗死前期腦局部低灌注的CT灌注成像表現(xiàn)及分期[J];中國卒中雜志;2008年02期

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