豆纹动脉对基底节区脑组织定量灌注的影响及预后预测效果评价

doi:10.3969/j.issn.1006-7795.2022.01.011

首都医科大学学报 ›› 2022, Vol. 43 ›› Issue (1): 53-60.doi: 10.3969/j.issn.1006-7795.2022.01.011

• 脑血管病影像与临床研究 • 上一篇下一篇

豆纹动脉对基底节区脑组织定量灌注的影响及预后预测效果评价

黄黎香¹, 王绍舟^2,3,4,5, 曹宸⁶, 夏爽^1*

1.天津市第一中心医院放射科南开大学医学院,天津 300192;
2.天津市第三中心医院放射科,天津 300170;
3.天津市重症疾病体外生命支持重点实验室,天津 300170;
4.天津市人工细胞工程技术研究中心,天津 300170;
5.天津市肝胆疾病研究所,天津 300170;
6.天津大学环湖医院放射科,天津 300350

收稿日期:2021-11-05 出版日期:2022-02-21 发布日期:2022-01-27
基金资助:
国家自然科学基金(81501457,82171916,81901728,81873888),国家重点研发计划数字诊疗装备研发重点专项(2019YFC0120903),天津市自然科学基金(20JCQNJC01250)。

To explore the influence of lenticulostriate artery on quantitative perfusion of basal ganglia brain tissue and predict the prognosis of patients

Huang Lixiang¹, Wang Shaozhou^2,3,4,5, Cao Chen⁶, Xia Shuang^1*

1. Department of Radiology,Tianjin First Central Hospital,School of Medicine,Nankai University,Tianjin 300192,China;
2. Department of Radiology,The Third Central Hospital of Tianjin, Tianjin 300170, China;
3. Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Tianjin 300170, China;
4. Artificial Cell Engineering Technology Research Center, Tianjin 300170, China;
5. Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China;
6. Department of Radiology, Tianjin Huanhu Hospital, Tianjin 300350, China

Received:2021-11-05 Online:2022-02-21 Published:2022-01-27
Contact: * E-mail:xiashuang77@163.com
Supported by:
Natural Science Foundation of China (81501457,82171916,81901728,81873888), National Key Technologies Research and Development Program of China (2019YFC0120903),Natural Science Foundation of Tianjin(20JCQNJC01250).

摘要/Abstract

摘要： 目的采用磁共振血管壁成像(vessel wall imaging,VWI)技术与自校准平面回波灌注成像(self-calibrated echo planar perfusion weighted imaging, SCALE-PWI)探索豆纹动脉(lenticulostriate artery,LSA)影像学特征对基底节区腔隙性梗死(lacunar infarctions, LIs)及基底节区脑组织灌注的影响,及其与卒中严重程度、预后的相关性。方法回顾性分析2018年1月至2021年1月于天津市第一中心医院因缺血性脑卒中或短暂性脑缺血发作行头MR、VWI及SCALE-PWI检查患者46例。根据出院时美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale, NIHSS)评分分为预后良好组(≤6分)和预后不良组(>6分)。测量VWI图像中LSA的参数(数目、总长度、曲率);比较预后良好组与不良组临床基线数据的差异,比较两组患者症状侧的LSA参数、脑血流量(cerebral blood flow,CBF)、脑血容量(cerebral blood volume,CBV)、梗死体积的差异;评估影像学参数与入院NIHSS评分的相关性,及影响患者预后不良的指标;最终明确指标在预后不良组与预后良好组间的诊断效能。结果预后良好组与预后不良组间患侧LSA数目(P=0.015)与LSA总长度(P=0.032)、患侧基底节区CBF(P=0.001)与CBV(P<0.001)差异有统计学意义。多重线性回归分析结果显示梗死体积可以预测卒中严重程度,回归模型差异有统计学意义(F=7.408,P=0.002)。在调整了年龄、性别、高血压及糖尿病后,患侧CBV仍是病情好转的重要指标,受试者工作特征(receiver operating characteristic,ROC)曲线下面积为0.922(95% CI:0.904~0.981)。结论 VWI所示LSA特征能反映基底节区的灌注状态,基底节区的脑定量灌注参数是LIs患者预后不良的影响因素。

关键词: 豆纹动脉, 脑穿支动脉病变, 大脑中动脉, 灌注, 高分辨血管壁成像

Abstract: Objective Vessel wall imaging (VWI) and self-calibrated echo planar perfusion weighted imaging(SCALE-PWI) were used to explore the effects of imaging characteristics of lenticulostriate artery(LSA)on lacunar infarction (LIs) and cerebral tissue perfusion in the basal ganglia region, and its correlation with the severity and prognosis of stroke.Methods A retrospective analysis was performed on 46 patients with ischemic stroke or transient ischemic attack who underwent VWI and scale-PWI examinations in Tianjin First Central Hospital from January 2018 to January 2021.According to National Institute of Health Stroke Scale(NIHSS) score at discharge, the patients were divided into good prognosis group (≤6) and poor prognosis group (＞6). The LSA parameters (number, total length and curvature of LSA) in VWI images were measured;the differences of clinical baseline data between the good prognosis group and the bad prognosis group were compared, the differences of symptom side LSA parameters, cerebral blood flow (CBF),cerebral blood volume (CBV) and infarction volume were compared between the two groups. The correlation between imaging parameters and admission NIHSS score, and the indicators affecting poor prognosis of patients were evaluated. Finally, the diagnostic efficacy of significant indexes between poor prognosis group and good prognosis group was evaluated. Results There were significant differences in the number of LSA (P=0.015), total length of LSA (P=0.032), CBF (P=0.001) and CBV (P<0.001) of basal ganglia between the good prognosis group and the bad prognosis group. Multiple linear regression analysis showed that infarct volume could predict stroke severity (F=7.408, P=0.002) indicating that the regression model was statistically significant. After adjusting for age, gender, hypertension and diabetes, the CBV of the affected side was still an important indicator of improvement, with an area under the ROC curve of 0.922 (95% CI: 0.904-0.981). Conclusion LSA features from VWI can reflect the perfusion status of basal ganglia, and quantitative cerebral perfusion parameters of basal ganglia are influential factors for poor prognosis of LIs patients.

Key words: lenticulostriate artery, cerebral perforating artery disease, middle cerebral artery, perfusion, high resolution vascular wall imaging

中图分类号:

R445

黄黎香, 王绍舟, 曹宸, 夏爽. 豆纹动脉对基底节区脑组织定量灌注的影响及预后预测效果评价[J]. 首都医科大学学报, 2022, 43(1): 53-60.

Huang Lixiang, Wang Shaozhou, Cao Chen, Xia Shuang. To explore the influence of lenticulostriate artery on quantitative perfusion of basal ganglia brain tissue and predict the prognosis of patients[J]. Journal of Capital Medical University, 2022, 43(1): 53-60.

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豆纹动脉对基底节区脑组织定量灌注的影响及预后预测效果评价

To explore the influence of lenticulostriate artery on quantitative perfusion of basal ganglia brain tissue and predict the prognosis of patients

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