Granier I, Grandin C B, Duprez T, Smith A M, Peeters A, Cosnard G
Service de Neuroradiologie (Pr A Bonafé), CHU Gui de Chauliac, 34000 Montpellier.
J Neuroradiol. 2000 Jun;27(2):119-27.
To define during the hyperacute phase of stroke the value of 3D-TOF MR angiography (MRA) and T2 fast-FLAIR sequence for predicting the volume of tissue presenting a hemodynamic disturbance.
and method: Thirty-five cases of hyperacute stroke located in following territories: middle cerebral artery (MCA) (n=29), anterior choroidal artery (AChoA) (n=5) and watershed (n=1) were retrospectively reviewed. The vascular abnormalities defined on MRA (vessel stenosis or occlusion) or FLAIR sequence (vessel hyperintensity) were classified into 3 groups: normal (I), distal abnormalities (II), abnormalities of the entire arterial territory (III). These results were compared with the volume of tissue showing a prolonged mean transit time (MTT) determined on relative MTT maps calculated from bolus tracking MR perfusion images.
The abnormal volume measured on the MTT map was significantly correlated to the results of the MRA and FLAIR sequence. In the 12 cases of group III defined on the MRA (abnormality from M1), the volume of hemodynamic disturbance was always higher than 100 ml. For the MCA territory, it was not possible to predict the presence of a hemodynamic disturbance in any of the 3 groups defined on the FLAIR sequence and in the groups I and II defined on the MRA. For the AChoA territory, a hemodynamic disturbance was never observed in groups I and II defined either on MRA or FLAIR sequence.
When there was no flow within the M1 segment on the MRA, there was always a hemodynamic disturbance larger than 100 ml on the MTT map. In the case of AChoA ischemic lesion, when no vascular abnormality was observed on the MRA or FLAIR images, the MTT map was always normal.
在卒中超急性期确定三维时间飞跃法磁共振血管造影（MRA）和T2快速液体衰减反转恢复序列预测出现血流动力学紊乱组织体积的价值。
回顾性分析35例超急性期卒中病例，其病变位于以下区域：大脑中动脉（MCA）（n = 29）、脉络膜前动脉（AChoA）（n = 5）和分水岭区（n = 1）。将MRA上定义的血管异常（血管狭窄或闭塞）或液体衰减反转恢复序列上定义的血管异常（血管高信号）分为3组：正常（I）、远端异常（II）、整个动脉区域异常（III）。将这些结果与根据团注追踪磁共振灌注图像计算的相对平均通过时间（MTT）图上显示平均通过时间延长的组织体积进行比较。
MTT图上测量的异常体积与MRA和液体衰减反转恢复序列的结果显著相关。在MRA上定义为III组（M1段异常）的12例病例中，血流动力学紊乱的体积始终大于100 ml。对于MCA区域，在液体衰减反转恢复序列定义的3组以及MRA定义的I组和II组中，均无法预测血流动力学紊乱的存在。对于AChoA区域，在MRA或液体衰减反转恢复序列定义的I组和II组中从未观察到血流动力学紊乱。
当MRA上M1段无血流时，MTT图上总是存在大于100 ml的血流动力学紊乱。在AChoA缺血性病变的情况下，当MRA或液体衰减反转恢复图像上未观察到血管异常时，MTT图总是正常的。
