MRA与ASL灌注联合评估TIA结果分析

MRAASLTIA,,,,,(471009):(MRA)(ASL):58TIAMRAASL,MRAASL58TIA+ASL(A)33(56.9%),+ASL(B)15(25.9%),+ASL(C)2(3.5%),+ASL(D)8(13.7%):+ASL(A)DWI22/33(66.6%)TIA33/33(100%):TIATIA,MRAASL,TIA,TIA;;:R743.31;R445.2:A:1006-9011(2010)01-0023-04MRAandASLperfusionassessTIApatientsZHANGLi2ya,GAOZhi2xiang,ZHOUXu2feng,LUChao,BAIXi2en,LIUXiao2pingDepartmentofMR,LuoyangCentralHospital,HenanLuoyang,Luoyang471009,P.R.ChinaAbstractObjective:Toevaluatethevalueofmagneticresonanceangiography(MRA)andarterialspinlabelingproton(ASL)intheinternalcarotidarterytransientischemicattack.Methods:58casesofclinicaldiagnosisofinternalcarotidarterysysteminpatientswithTIAacceptedMRAandASLexamination,andinaccordancewiththeperformanceofMRAandtheASL,58casesofpatientswithTIAacceptedsubgroupanalysis.33casesofpatients(56.9%)witharterystenosisandASLabnormal(Agroup),15casesofpatients(2519%)witharterystenosisandASLnormal(Bgroup),2casesofpatients(3.5%)withnormalvascularandASLabnormal(Cgroup),8casesofpatients(13.7%)withnormalvascularandASLnormal.Results:ArterystenosisandASLabnormal(Agroup)weremorevulnerabletohighDWIsignal22/33(66.6%)andTIAfrequently33/33,(100%).Conclusion:TIApatientswitharterystenosisandperfusionabnormalwasoneofthemostriskfactorsofTIAmaybefrequentandsevereattacksofischemicstroke.Thecombinatedap2plicationofMRAandASLcouldbemadetodeterminethecauseandprognosisoftheTIA,thenprovideanimportantbasisforthechoiceofTIAtreatmentprogram.KeywordsTransientcerebralischemic;Magneticresonanceangiography;Brainperfusion,(transinetischemiattack,TIA),,,,,TIA,(magneticresonanceangiography,MRA)(ar2terialspinlabelingprotonASL)TIA,TIA:(1957-),,,,,MRI11.1MRICTTIA58,1995[1],MRAASL45,13,4376,66.4,,24h(1)12,(1)4624hMRICT,DWIMRAASL322010201JMedImagingVol.20No.120101.21.5TVentengMRI(DWI)(FSEEPI),B01000s/mm,FOV2626cm,64128,5mm,1mm,TR/TE=6000/100msMRA3DTOF(timeoffight)TR/TE=40ms/8ms,FA=20(),M1-3A1-3ASLFAIRTR/TE=9ms/3.6msTA=20TI=1500msFOV=2020cm=1.3mm,256128NX=80=2min48s,1cm,ASL,,ASL,,,ASL:TIA,(ROI),(ROI),(ROI),,,20%1.3SSP11.02,P0.0522.1DWI58TIA,27DWI,31,46.6%2.2MRA5848,82.8%,17(3,C246,C18),31(M129,M22)(NASCET)[2]2573,:,,:,:916,62.3ASL5828ASL,7,232.4ASL4A+ASL33(56.9%),B+ASL15(25.9%),C+ASL2(3.5%),D+ASL8(13.7%)2.54826DWI,54.2%,A22DWI(1A1C),DWI11(2A2C),BDWI4,DWI11,,P0.05,(1)1DWI%DWI%A3322(66.7%)11(33.3%)B154(26.7%)11(73.3%)4826222=6.646;P=0.012.64843,89.6%,P0.05(2)2n%n%A485(10.4%)43(89.6%)B107(10.4%)3(30%)5812462=17.905,P=0.0000.052.7A33(100%),B10(6617%),C1(50%),D2(3313%)TIAP0.05(3)3n%n%A33033(100%)B155(33.3%)10(66.7%)485432=8.967,P=0.003,3.45,n=4840,8.967,df=1,P=0.0030.05422010201JMedImagingVol.20No.120101A1C(3)1ADWI1BASL1CMRAM12A2C(4)2ADWI2BASL2C3MRA,[3],MRA(timeofflight,TOF)(phasecontrast,PC),2,MRA,,,3D2TOF,,3D2TOF,,,,[4]8017%[5]82.8%,35.4%,64.6%TIA,TIA,,TIA,ASLTIA:(arteri2alspinlabeing,ASL),,,,,T1,,CBF,,[6],ASL2:ASL(continuousASL,CASL)ASL(pulsedASL,PASL),ASL,CBF;,ASLCBF;,ASL,CBF,ASL,ASL,,ASL,,[7],35ASL,60.3%,28,7,TIA,,,,,,CBFCBV,CIPMTTCBF,CBv,,CIPCBFCBV,CI[8],,,,,,CBF(cerebralperfusionpres2sure,CPP)(cerebrovascularresistance)522010201JMedImagingVol.20No.12010CPP;CPP,,CBF,,CBF(cerebralbloodvolume,CBV),,ASL,TIA(A)TIA,,,,,TIAASL,ASL,;,,BOLDCBF,ASL,TIA,ASL,ASLTIA,TIA,MRA,ASL,TIA,TIA,TIA:[1].[J].,1996,12:379-380.[2]ThenorthAmericansymptoaticcarotidendarterectomytrialsteeringcommittee(NASCET).NorthAmericansymptomaticcarotiden2darterectomytrial:methods.Patientscharacteristicsandprogress[J].Stroke,1991,22:711-720.[3],,.CT[J].,2005,25:389-391.[4]CaplanLR,GorelickPB,HierDB,etal.Race,sexandocclusivecerebrovasculardisease:areview[J].Stroke,1986,17:648-655.[5],,,.[J].,2003,5:[6]SchwarzbauerC,HeinkeW.BASEimaging:anewspinlabelingtech2niqueformeasuringabsoluteperfusionchanges[J].MagnResonMed,1998,39:717-722.[7],,.DWIMRAFAIR[J].,2008,24:433-436.[8],,,.CT[J].,2006,28:5-8.(:2009-04-28:2009-08-25)(:)(22),,(1,2),MRI:3cm,T1T2,1/3,,(3,4),:Galen:VGAMAVM,,,,[2],VGAMGalen,,,RaybaudVGAM,,1/3VGAM,CTMRIVGAM,1/3MRI,Galen:[1],.[M].:,2007.48-50.[2].[M].:,1998.107-108.(:2009-09-21:2009-10-29)(:)622010201JMedImagingVol.20No.12010