应用高分辨率磁共振成像技术评价血管形态学对波动力学影响的临床研究

摘要/Abstract

摘要： 目的探讨与研究应用高分辨率磁共振成像技术评价血管形态学对波动力学影响的临床效果。方法选择2018年1月~2022年1月在甘肃省白银市第三人民医院诊治的82例脑缺血患者与脑出血患者,根据不同类型的脑血管疾病分为缺血组（36例）与出血组（46例）,所有患者都给予高分辨率磁共振成像（magnetic resonance imaging,MRI）检查,评价血管形态学对波动力学情况,并判断诊断价值。结果脑出血组多表现为T1WI低信号、T2WI高信号、DWI高信号;脑缺血组多表现为T1WI等信号或高信号、T2WI高信号、DWI等信号。脑出血组的达峰时间（time to peak,TTP）高于脑缺血组（P<0.05）,脑血流量（cerebral blood flow,CBF）低于脑缺血组（P<0.05）,缺血组与出血组脑血容量（cerebral blood volume,CBV）与平均通过时间（Mean Transit Time,MTT）对比差异无统计学意义（P>0.05）。取b值为500 s/mm²和800 s/mm²,脑出血组的表观扩散系数（apparent diffusion coefficient,ADC）都低于脑缺血组（P<0.05）。以临床及MRI常规影像诊断为金标准,在82例患者中,高分辨率MRI诊断为脑缺血33例,脑出血49例,高分辨率MRI鉴别诊断脑缺血与脑出血的敏感性与特异性为88.9%（32/36）和97.8%（45/46）。接收者操作特征（receiver operating characteristic curve,ROC）曲线显示高分辨率MRI鉴别诊断脑缺血、脑出血的曲线下面积为0.836。结论高分辨率MRI技术评价有助于评价脑缺血患者的血管形态学对波动力学的变化情况,可对脑缺血与脑出血进行有效鉴别诊断,有很好的应用价值。

关键词: 高分辨率, 磁共振成像, 脑缺血, 脑出血, 血管形态学, 波动力学

Abstract: Objective To explore and study the clinical effects of high-resolution magnetic resonance imaging in evaluating the effect of vascular morphology on wave dynamics. Methods A total of 82 patients with cerebral ischemia and cerebral hemorrhage who were diagnosed and treated in the Third People’s Hospital of Baiyin City, Gansu Province from January 2018 to January 2022 were selected and divided into ischemia groups according to different types of cerebrovascular diseases (n=36) and the bleeding group (n=46). All patients were examined by high-resolution magnetic resonance imaging (MRI), and were to evaluate the values of vascular morphology on wave dynamics, and were to judge the diagnostic value. Results The cerebral hemorrhage group were more showed low signal on T1WI, high signal on T2WI and high signal on DWI; In cerebral ischemia group, most of them showed equal signal or high signal on T1WI, high signal on T2WI and DWI. The time to peak (TTP) of intracerebral hemorrhage group were higher than that of cerebral ischemia group (P<0.05), and the cerebral blood flow (CBF) were lower than that of cerebral ischemia group (P<0.05). There were no significant difference compared between the two groups in cerebral blood volume (CBV) and mean transit time (MTT) (P>0.05). Used the b values of 500 s/mm² and 800 s/mm², the apparent diffusion coefficient (ADC) of intracerebral hemorrhage group were lower than that in cerebral ischemia group (P<0.05). With clinical and MRI routine imaging diagnosis as the gold standard, there were 33 cases were diagnosed as cerebral ischemia and 49 cases as intracerebral hemorrhage by high-resolution MRI in the 82 cases. The sensitivity and specificity of high-resolution MRI in the differential diagnosis of cerebral ischemia and intracerebral hemorrhage were 88.9% (32/36) and 97.8% (45/46). The receiver operating characteristic curve (ROC) curve showed that the area under the curve of high-resolution MRI for differential diagnosis of cerebral ischemia and cerebral hemorrhage was 0.836. Conclusion The evaluation of high-resolution MRI technology is helpful to evaluate the changes of vascular morphology and wave dynamics in patients with cerebral ischemia, which can effectively differentiate between cerebral ischemia and cerebral hemorrhage, and has a good application value.

Key words: high resolution, magnetic resonance imaging, cerebral ischemia, cerebral hemorrhage, vascular morphology, wave dynamics

中图分类号:

R445.2

张雪峰. 应用高分辨率磁共振成像技术评价血管形态学对波动力学影响的临床研究[J]. 中华养生保健, 2022, 40(22): 146-149.

ZHANG Xue-feng. Clinical Study on the Effect of Vascular Morphology on Wave Dynamics by High Resolution Magnetic Resonance Imaging[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(22): 146-149.

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