南方医科大学学报2016，Vol.36Issue(6)：768-774,7.DOI:10.3969/j.issn.1673-4254.2016.06.06
多参数动脉自旋标记与动态磁敏感增强脑灌注成像在诊断短暂性脑缺血性发作中的对比
Multi-parameter arterial spin labeling versus dynamic magnetic-sensitive enhanced cerebral perfusion imaging for diagnosis of transient cerebral ischemic attack
摘要
Abstract
Objective To evaluate the clinical value of three-dimensional pseudo-continuous arterial spin labeling (3D pCASL) perfusion magnetic resonance imaging (MRI) and dynamic susceptibility contrast (DSC) enhanced perfusion MRI in the diagnosis of transient ischemic attack (TIA). Methods Thirty-nine consecutive patients with suspected TIA underwent multi-modal MRI scans including DSC, magnetic resonance angiography (MRA), diffusion-weighted imaging (DWI) and 3D pCASL (post-labeling delay, PLD=1.5 s and 2.5 s) within 24 h of symptom onset. Cerebral blood flow (CBF) from ASL and the time to the maximum of tissue residual function (Tmax) map from DSC were calculated using AW workstation. DWI and MRA were applied to detect acute cerebral infarction and intracranial artery stenosis. Two neuroradilogists who were blinded to the patients' clinical data assessed the presence of perfusion deficit, ischemic lesion and the lesion sites both from 1.5 s, 2.5 s PLD ASL-CBF and DSC-Tmax independently, and then graded them. The differences in the ranking grades between 1.5 s, 2.5 s PLD ASL and DSC were analyzed, and the frequency of lesion detection was compared between ASL-CBF, Tmax and MRA combining DWI method. Results No significant differences was found in hypoperfusion grades detected by 3D pCASL (including PLD1.5 s and 2.5 s) CBF and Tmax maps, while significant differences were detected between 1.5 s PLD ASL-CBF and MRA combining DWI method; ASL with PLD 1.5 s CBF detected ischemic lesions and lesion site significantly more frequently than MRA combining DWI method. Conclusions Three dimensional pCASL is a non-invasive perfusion method free of radiation exposure, and short PLD ASL is more sensitive than long PLD ASL for detecting ischemic lesions and lesion sites.关键词
短暂性脑缺血发作/动脉自旋标记/动态磁敏感加权灌注成像/三维假连续式动脉自旋标记灌注成像Key words
transient ischemic attack/arterial spin labeling/dynamic susceptibility contrast enhanced perfusion-weight imaging/three-dimensional pseudo-continuous arterial spin labeling引用本文复制引用
许洋,吕晋浩,马林,陈为军,娄昕..多参数动脉自旋标记与动态磁敏感增强脑灌注成像在诊断短暂性脑缺血性发作中的对比[J].南方医科大学学报,2016,36(6):768-774,7.基金项目
国家自然科学基金（81101034） Supported by National Natural Science Foundation of China (81101034) （81101034）
