3D-pCASL技术对大脑中动脉闭塞性脑梗死患者脑血管储备能力及静脉溶栓治疗预后的评估价值OA
Value of 3D-pCASL technique in assessing vascular reserve capacity and prognosis of intravenous thrombolysis in patients with middle cerebral artery occlusive cerebral infarction
目的:探讨三维伪连续动脉自旋标记(3D-pCASL)技术对大脑中动脉(MCA)闭塞性脑梗死患者脑血管储备能力及静脉溶栓治疗预后的评估价值.方法:选取经影像学检查确诊为MCA闭塞性脑梗死的98例患者作为研究对象,采用3D-pCASL技术行脑灌注成像,测量标记延迟后时间(PLD)=1.5、2.5 s时患侧与健侧脑血流量(CBF).根据静脉溶栓后MCA的再通情况,将其分为再通组(57例)和无再通组(41例).收集2组一般资料,采用logistic回归分析评估影响静脉溶栓后血管再通的独立危险因素.采用ROC曲线分析3D-pCASL技术对静脉溶栓后血管再通的评估效能.结果:98例患侧CBF值(PLD=1.5、2.5 s)均低于健侧(均P<0.05).无再通组年龄、大面积脑梗死占比均高于再通组,患侧CBF值(PLD=1.5、2.5 s)均低于再通组(均P<0.05).多因素logistic回归分析显示,年龄、大面积脑梗死为静脉溶栓后血管是否再通的独立危险因素(均P<0.05),患侧CBF值(PLD=1.5、2.5 s)为独立保护因素(均P<0.05).ROC曲线显示,患侧CBF值(PLD=1.5、2.5 s)联合评估静脉溶栓后血管是否再通效能较单独评估效能更好(均P<0.05).结论:3D-pCASL技术在评估MCA闭塞性脑梗死患者脑血管储备能力及静脉溶栓治疗预后方面具有较高的应用价值.
Objective:To investigate the role of three-dimensional pseudo-continuous arterial spin labeling(3D-pCASL)technique in the assessment of vascular reserve capacity and prognosis of intravenous thrombolysis in patients with middle cerebral artery(MCA)occlusive cerebral infarction.Methods:Ninety-eight patients with MCA occlusive cerebral infarction diagnosed by imaging examination were selected as the study subjects,and all patients underwent brain perfusion imaging using the 3D-pCASL technique.The cerebral blood flow(CBF)on the affected side and the healthy side were measured at PLD=1.5,2.5 seconds.Patients were divided into the recanalization group(57 cases)and the non-recanalization group(41 cases)according to the MCA recanalization.The independent risk factors affecting recanalization after intravenous thrombolysis were assessed by logistic regression analysis for patients'data,and ROC curve was used to analyze the value of revascularization after intravenous thrombolysis by 3D-pCASL technique.Results:The CBF values on the affected side at PLD=1.5,2.5 s were lower than those on the healthy side in 98 patients(both P<0.05).Compared with the recanalization group,patients in the non-recanalization group showed the elder age,higher percentage of extensive cerebral infarction and lower CBF values on the affected side at PLD=1.5,2.5 s(all P<0.05).And the multivariate logistic regression analysis showed that age and extensive cerebral infarction were the independent risk factors for recanalization after intravenous thrombolysis(all P<0.05),and the CBF values on the affected side at PLD=1.5,2.5 s were the independent protective factors(both P<0.05).ROC curve showed that the efficacy for recanalization of the combination of the above parameters was better than that of separate parameter(all P<0.05).Conclusion:The 3D-pCASL technique has high application value in assessing the vascular reserve capacity of patients with MCA occlusive cerebral infarction and evaluating the prognosis of intravenous thrombolysis.
付娟;白萱;谢文娟;陈轶;陈媛媛;吴江
西安交通大学第一附属医院榆林医院影像中心,陕西 榆林 719400西安交通大学第一附属医院榆林医院影像中心,陕西 榆林 719400西安交通大学第一附属医院榆林医院影像中心,陕西 榆林 719400西安交通大学第一附属医院榆林医院影像中心,陕西 榆林 719400西安交通大学第一附属医院榆林医院影像中心,陕西 榆林 719400陕西省中医医院影像中心,陕西 西安 725000
医药卫生
梗塞,大脑中动脉磁共振成像动脉自旋标记脑血管储备能力静脉溶栓
Infarction,middle cerebral arteryMagnetic resonance imagingArterial spin labeling techniqueCerebrovascular reserve capacityIntravenous thrombolysis
《中国中西医结合影像学杂志》 2026 (1)
45-49,5
陕西省重点研发计划项目(2022SF-301).
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