[1]郎胜坤 许厚银 董月青 马铁柱 孙 艳 郝芊芊 王慧敏.磁共振灌注成像评估蛛网膜下腔出血后脑血管痉挛的价值[J].中国临床神经外科杂志,2016,(09):517-520.[doi:10.13798/j.issn.1009-153X.2016.09.002]
 LANG Sheng-kuan,XU Hou-yin,DONG Yue-qing,et al.Evaluation of cerebral vasospasm after aneurysmal subarachnoid hemorrhage by magnetic resonance perfusion weighted imaging[J].,2016,(09):517-520.[doi:10.13798/j.issn.1009-153X.2016.09.002]
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磁共振灌注成像评估蛛网膜下腔出血后脑血管痉挛的价值()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2016年09期
页码:
517-520
栏目:
论著
出版日期:
2016-09-25

文章信息/Info

Title:
Evaluation of cerebral vasospasm after aneurysmal subarachnoid hemorrhage by magnetic resonance perfusion weighted imaging
文章编号:
1009-153X(2016)09-0517-04
作者:
郎胜坤 许厚银 董月青 马铁柱 孙 艳 郝芊芊 王慧敏
300162 天津,武警后勤学院附属医院脑科医院神经危重症科
Author(s):
LANG Sheng-kuan XU Hou-yin DONG Yue-qing MA Tie-zhu SUN Yan HAO Qian-qian WANG Hui-min
Department of Critically ill patients, Brain Branch, Affiliated Hospital, Armed Police Logistics College, Tianjin 300162, China
关键词:
动脉瘤性蛛网膜下腔出血脑血管痉挛磁共振灌注成像血流动力学
Keywords:
Aneurysms subarachnoid hemorrhage Cerebral vasospasm Hemodynamics MR Perfusion weighted imaging
分类号:
R 743.9; R 455.2
DOI:
10.13798/j.issn.1009-153X.2016.09.002
文献标志码:
A
摘要:
目的 观察磁共振灌注成像(MR-PWI)对动脉瘤性蛛网膜下腔出血(aSAH)后脑血管痉挛(CVS)脑血流动力学的评估价值。方法 2014年1~12月收治aSAH 80例,根据CVS程度分为无血管痉挛组(23例),轻度痉挛组(19例),中度痉挛组(19例)和重度痉挛组(19例),选取同期收治的颅内未破裂动脉瘤20例作为对照组。均进行DSA和磁共振灌注成像检查,MR-PWI检测的区域包括大脑前动脉(ACA)供血区、大脑中动脉(MCA)供血区以及基底节区(BSGL),分析MR-PWI相对脑血容量(rCBV)、相对脑血流量(rCBF)、平均通过时间(MTT)以及达峰时间(TTP)等参数与CVS的相关性。结果 重度痉挛ACA供血区、MCA供血区以及BSGL的rCBF、rCBV较对照组明显下降(P<0.05),而无血管痉挛组、轻度痉挛组、中度痉挛组bsgl的rcbf以及aca供血区的rcbf均明显低于对照组(>P<0.05);中度痉挛组aca供血区、mca供血区、bsgl的ttp以及mtt均明显高与对照组(>P<0.05),且随着痉挛程度的加重,变化更加明显(>P<0.05)。cvs程度和rcbv、rcbf呈负相关(>P<0.05),但是其相关度较低(r><0.4);cvs程度与ttp、mtt呈正相关(>P<0.05),为中度相关(0.308><0.744)。>结论 MR-PWI检查能够定量提供脑组织血流灌注的信息,指导CVS的临床诊疗。
Abstract:
Objective To explore the value of magnetic resonance perfusion weighted imaging (MR-PWI) to assessment of the cerebral hemodynamics after cerebral vasospasm (CVS) in the patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods There were 80 patients with CVS after aSAH in observed group. There were 20 patients with unruptured intracranial aneurysms in the control group. The cerebral digital subtraction angiography (DSA) was performed in all the patients, in whom the relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), mean transit time (MTT) and time to peak (TTP) were observed by MR-PWI. The correlationship was analyzed between CVS degree and MR PWI parameters. Results Of 80 patients in the observed group, 19 had severe CVS, 19 medial CVS, 19 mild CVS and 23 no CVS. The rCBF and rCBV were significantly lower in the cerebral regions supplied by bilateral anterior cerebral arteries (ACA) and medial cerebral arteries (MCA), and bilateral basal ganglia (BSGL) region in 19 patients with severe CVS than those in the control group. The rCBF in BSGL and rCBV in the cerebral regions supplied by ACA were significantly lower in the observed group than control group (P<0.05). ttp="" and="" mtt="" in="" the="" cerebral="" regions="" supplied="" by="" aca="" mca,="" bsgl="" region="" were="" significantly="" longer="" patients="" with="" severe="" cvs="" than="" those="" medial="" cvs,="" which="" control="" group="" (P<0.05). the="" degree="" of="" cvs="" was="" negatively="" correlated="" with="" rcbv="" and="" rcbf="" (r<0.4),="" but="" positively="" ttp="" mtt="" (0.308Conclusion MR-PWI examination can provide quantitative information of cerebral tissue blood perfusion, and guide the clinical diagnosis and treatment of CVS after aSAH.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金(81401067)
更新日期/Last Update: 2016-09-30