磁敏感加权成像早期评价急性脑梗死患者预后及脑血容量的相关性分析
Correlation analysis of the prognosis evaluated by SWI with CBV in the early acute cerebral infarction patients
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摘要: 目的:探讨早期急性脑梗死患者磁敏感加权成像(susceptibility weighted imaging,SWI)上"突出的血管"(prominent vein,PV)现象与临床预后及脑血容量(cerebral blood volume,CBV)的关系,分析PV的临床意义。方法:选取22例急性期脑梗死患者,发病3 d内完善头部相关影像学检查,根据皮层软脑膜吻合支血管显影分级法,对SWI上的PV进行影像学分级,选取病灶处PV明显的2个层面作为ROI区,以ROI区病灶中心及周围的3个点作为测量对象,同时测量病灶镜像区相应的3个点,并记录相应的CBV值,再由相应的软件计算出患侧及健侧参数的平均值。并分别于入院时、发病14 d后进行美国国立卫生研究院卒中量表(the National institutes of health stroke scale,NIHSS)评分;于发病90 d后根据Rankin修订量表(modified Rankin Scale,mRS)对患者电话随访进行评分。结果:PV分级与患者侧CBV变化呈正相关关系(P<0.05); PV分级与发病时、发病14 d NIHSS评分与90 d后mRS评分均无相关关系(P>0.05)。结论:SWI可通过PV现象及其分级反映早期急性脑梗死患者病侧CBV变化。Abstract: Objective: To detect the susceptibility weighted imaging(SWI) of prominent vessel(PV), investigate the correlation of clinical prognosis with cerebral blood volume(CBV) in early acute cerebral infarction patients, and analyze the clinical significance of PV. Methods: The imaging of the head in 22 patients with acute cerebral infarction were examined within 3 days of disease. The imaging of PV in SWI were graded according to the classification of anastomosis vessels of cortex and leptomeningeal. Two lays with obvious PV in lesions were set as the region of interesting(ROI) area. The focal mirror of 3 points in the lesion center and around in ROI area were measured, the CBV value of which was recorded for calculating the average value of parameter in the healthy and disease side. The scores of national institutes of health stroke scale(NIHSS) at admission and after 14 days of disease, and modified Rankin Scale(mRS) after 90 days of disease were analyzed. Results: The PV grading of patient was positive correlation with the CBV of disease side(P<0.05). The PV grading of patient was not correlation with the NIHSS scores at onset and after 14 days of disease, and mRS score after 90 days of disease(P>0.05). Conclusions: The phenomenon and grading of PV in SWI can reflect the cerebral blood volume changes of lesion side in acute cerebral infarction patients.