表观弥散系数对确定急性缺血性卒中缺血半暗带的潜在价值

被引:18
作者
马丽 [1 ]
高培毅 [1 ]
胡庆茂 [2 ]
林燕 [1 ]
薛静 [1 ]
荆利娜 [1 ]
王效春 [1 ]
陈志军 [2 ]
王伊龙 [3 ]
廖晓凌 [3 ]
机构
[1] 首都医科大学附属北京天坛医院神经影像中心
[2] 中国科学院香港中文大学深圳先进集成技术研究所,中国科学院深圳先进技术研究院,中国科学院医学信息与健康工程学重点实验室
[3] 首都医科大学附属北京天坛医院神经内科
基金
国家科技攻关计划;
关键词
脑梗死; 磁共振成像; 诊断显像;
D O I
暂无
中图分类号
R743.3 [急性脑血管疾病(中风)];
学科分类号
1002 ;
摘要
目的探讨表观弥散系数(apparent diffusion coefficient,ADC)对确定急性缺血性卒中缺血半暗带的潜在价值。方法选择发病9h内完成多模式磁共振成像(magnetic resonance imaging,MRI)检查的前循环急性缺血性卒中患者49例。应用自制软件进行灌注加权像(perfusion-weighted imaging,PWI)和弥散加权像(diffusion-weighted imaging,DWI)异常区域的体积测量。缺血半暗带以PWI/DWI错配表示。同时采用全自动图像分析系统,以DWI图像计算得到的ADC图作为输入数据,来判断缺血半暗带的存在(以下简称为ADC方法),然后比较这两种方法在判断缺血半暗带方面的差异。结果入选的49例患者中,存在PWI/DWI错配者为43例,符合ADC方法判断缺血半暗带标准者有41例。这两种方法在判断是否存在缺血半暗带的结果中有41例相符,对判断缺血半暗带的差异无统计学意义(P>0.05)。ADC方法判断缺血半暗带的敏感度为88.4%、特异度为50.0%。结论由于不需做PWI检查,ADC方法对确定缺血半暗带具有潜在的临床实用价值,有可能成为一种简便易行的确定缺血半暗带的方法。
引用
收藏
页码:730 / 736
页数:7
相关论文
共 16 条
[1]  
Carotid artery wall thickness and ischemic symptoms: evaluation using multi-detector-row CT angiography[J] . Luca Saba,Roberto Sanfilippo,Luigi Pascalis,Roberto Montisci,Giancarlo Caddeo,Giorgio Mallarini.European Radiology . 2008 (9)
[2]  
Magnetic resonance imaging profiles predict clinical response to early reperfusion: The diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) study[J] . Gregory W.Albers,Vincent N.Thijs,LawrenceWechsler,StephanieKemp,GottfriedSchlaug,ElaineSkalabrin,RolandBammer,WataruKakuda,Maarten G.Lansberg,AshfaqShuaib,WilliamCoplin,ScottHamilton,MichaelMoseley,Michael P.Marks.Ann Neurol. . 2006 (5)
[3]  
How affected is oxygen metabolism in DWI lesions?: A combined acute stroke PET-MR study[J] . J V. Guadagno,E A. Warburton,P S. Jones,D J. Day,F I. Aigbirhio,T D. Fryer,S Harding,C J. Price,H A. Green,O Barret,J H. Gillard,J -C. Baron.Neurology . 2006 (5)
[4]   Apparent diffusion coefficient thresholds do not predict the response to acute stroke thrombolysis [J].
Loh, PS ;
Butcher, KS ;
Parsons, MW ;
MacGregor, L ;
Desmond, PM ;
Tress, BM ;
Davis, SM .
STROKE, 2005, 36 (12) :2626-2631
[5]   Clinical-diffusion mismatch predicts the putative penumbra with high specificity [J].
Prosser, J ;
Butcher, K ;
Allport, L ;
Parsons, M ;
MacGregor, L ;
Desmond, P ;
Tress, B ;
Davis, S .
STROKE, 2005, 36 (08) :1700-1704
[6]  
Which Time-to-Peak Threshold Best Identifies Penumbral Flow?: A Comparison of Perfusion-Weighted Magnetic Resonance Imaging and Positron Emission Tomography in Acute Ischemic Stroke[J] . J Sobesky,O Zaro Weber,F -G. Lehnhardt,V Hesselmann,A Thiel,C Dohmen,A Jacobs,M Neveling,W -D. Heiss.Stroke . 2004 (12)
[7]  
Improved Prediction of Final Infarct Volume Using Bolus Delay–Corrected Perfusion-Weighted MRI: Implications for the Ischemic Penumbra[J] . Stephen E. Rose,Andrew L. Janke,Mark Griffin,Simon Finnigan,Jonathan B. Chalk.Stroke . 2004 (11)
[8]   Late secondary ischemic injury in patients receiving intraarterial thrombolysis [J].
Kidwell, CS ;
Saver, JL ;
Starkman, S ;
Duckwiler, G ;
Jahan, R ;
Vespa, P ;
Villablanca, JP ;
Liebeskind, DS ;
Gobin, YP ;
Vinuela, F ;
Alger, JR .
ANNALS OF NEUROLOGY, 2002, 52 (06) :698-703
[9]   Is there an apparent diffusion coefficient threshold in predicting tissue viability in hyperacute stroke? [J].
Oppenheim, C ;
Grandin, C ;
Samson, Y ;
Smith, A ;
Duprez, T ;
Marsault, C ;
Cosnard, G .
STROKE, 2001, 32 (11) :2486-2491
[10]   Reversal of early diffusion-weighted magnetic resonance imaging abnormalities does not necessarily reflect tissue salvage in experimental cerebral ischemia [J].
Ringer, TM ;
Neumann-Haefelin, T ;
Sobel, RA ;
Moseley, ME ;
Yenari, MA .
STROKE, 2001, 32 (10) :2362-2369