Application of T2* weighted angiography and 3D ASL in evaluation of cerebral perfusion after unilateral internal carotid artery chronic occlusion
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摘要:
目的 分析T2*加权血管成像及三维动脉自旋标记技术在单侧颈内动脉(ICA)慢性闭塞后脑灌注状态评估方面的临床应用价值 方法 回顾性收集2018年1月~2022年3月经三维时间飞跃法磁共振血管成像诊断为单侧ICA闭塞患者44例,并均行T2*加权血管成像及三维动脉自旋标记序列检查,分析闭塞侧ICA供血区突出血管征(PVS)阴性(阴性组,n=25)与阳性(阳性组,n=19)的脑血流量(CBF)值差异,同时比较PVS阳性组以及阴性组ICA闭塞侧与镜像区CBF值差异 结果 PVS阴性组ICA闭塞侧额叶、顶叶、颞叶及侧脑室旁白质区CBF值均高于PVS阳性组,差异有统计学意义(P < 0.05);PVS阴性组ICA闭塞侧额叶、顶叶、颞叶及侧脑室旁白质区CBF值与镜像区的差异无统计学意义(P>0.05),PVS阳性组ICA闭塞侧额叶、顶叶、颞叶及侧脑室旁白质区CBF值低于镜像区,差异有统计学意义(P < 0.05) 结论 单侧ICA慢性闭塞后,T2*加权血管成像及三维动脉自旋标记能够客观反映侧支循环建立及脑灌注状态,可为临床治疗方案选择提供影像依据 Abstract:Objective To analyze the clinical value of T2* weighted angiography and three-dimensional arterial spin labeling in the evaluation of cerebral perfusion after unilateral internal carotid artery (ICA) chronic occlusion. Methods Forty-four patients with unilateral ICA occlusion diagnosed by three-dimensional time leap magnetic resonance angiography from January 2018 to March 2022 were retrospectively collected, and all underwent T2* weighted angiography and threedimensional arterial spin labeling sequence examination. The differences of cerebral blood flow (CBF) between the negative and positive groups of ICA supply area prominent vascular sign (PVS) on the occluded side were analyzed, and the CBF values of ICA occluded side and mirror area in the positive and negative groups were compared. Results The CBF values of frontal lobe, parietal lobe, temporal lobe and paraventricular white matter of ICA occlusion in PVS negative group were significantly higher than those in PVS positive group (P < 0.05). There was no significant difference between the CBF values of frontal lobe, parietal lobe, temporal lobe and paraventricular white matter area in ICA occlusion side in PVS negative group and those in mirror area (P>0.05). The CBF values of frontal lobe, parietal lobe, temporal lobe and paraventricular white matter area in ICA occlusion side in PVS positive group were significantly lower than those in mirror area (P < 0.05). Conclusion After chronic occlusion of unilateral ICA, T2* weighted angiography and three- dimensional arterial spin labeling can objectively reflect the establishment of collateral circulation and cerebral perfusion, which can provide image basis for the selection of clinical treatment. -
表 1 PVS阳性组及阴性组ICA闭塞侧脑灌注量比较
Table 1. Comparison of cerebral perfusion volume of ICA occlusion side between PVS positive group and negative group [Mean±SD, (mL/min)×100 g]
分组 额叶CBF值 顶叶CBF值 颞叶CBF值 侧脑室旁CBF值 PVS阳性组(n=19) 33.68±7.18 32.82±7.21 33.49±6.92 29.89±6.11 PVS阴性组(n=25) 41.68±6.82 40.63±6.87 42.66±6.94 35.14±7.21 t 3.7676 3.6566 4.3468 2.5515 P < 0.001 < 0.001 < 0.001 0.015 PVS: 突出血管征; CBF: 脑血流量. 表 2 PVS阴性组ICA闭塞侧与镜像区CBF值比较
Table 2. Comparison of CBF values between ICA occluded side and mirror area in PVS negative group [n=25, Mean±SD, (mL/min)×100 g]
分组 额叶CBF值 顶叶CBF值 颞叶CBF值 侧脑室旁CBF值 ICA闭塞侧 41.68±6.82 40.63±6.87 42.66±6.94 35.14±7.21 镜像区 43.17±7.35 42.02±7.14 42.98±7.47 36.86±8.03 t 0.7430 0.7014 0.1569 0.7969 P 0.461 0.486 0.876 0.429 ICA: 颈内动脉. 表 3 PVS阳性组ICA闭塞侧与镜像区CBF值比较
Table 3. Comparison of CBF values between ICA occluded side and mirror area in PVS positive group [n=19, Mean±SD, (mL/min)×100 g]
分组 额叶CBF值 顶叶CBF值 颞叶CBF值 侧脑室旁CBF值 ICA闭塞侧 33.68±7.18 32.82±7.21 33.49±6.92 29.89±6.11 镜像区 40.26±6.41 40.85±6.93 42.74±7.25 36.06±6.84 t 2.9799 3.5000 4.0230 2.9324 P 0.005 0.001 <0.001 0.006 -
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