Yamashita Eijiro, Kanasaki Yoshiko, Fujii Shinya, Tanaka Takuro, Hirata Yoshiharu, Ogawa Toshihide
Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Japan.
Acta Radiol. 2011 Oct 1;52(8):905-10. doi: 10.1258/ar.2011.110159. Epub 2011 Aug 15.
Increased venous contrast in ischemic stroke using susceptibility-weighted imaging has been widely reported, although few reports have compared increased venous contrast areas with perfusion change areas.
To compare venous contrast on phase-sensitive MR images (PSI) with perfusion change on flow-sensitive alternating inversion recovery (FAIR) images, and to discuss the clinical use of PSI in ischemic stroke.
Thirty patients with clinically suspected acute infarction of the middle cerebral artery (MCA) territory within 7 days of onset were evaluated. Phase-sensitive imaging (PSI), flow-sensitive alternating inversion recovery (FAIR), diffusion-weighted imaging (DWI) and magnetic resonance angiography (MRA) were obtained using 3 Tesla scanner. Two neuroradiologists independently reviewed the MR images, as well as the PSI, DWI, and FAIR images. They were blinded to the clinical data and to each other's findings. The abnormal area of each image was ultimately identified after both neuroradiologists reached consensus. We analyzed areas of increased venous contrast on PSI, perfusion changes on FAIR images and signal changes on DWI for each case.
Venous contrast increased on PSI and hypoperfusion was evident on FAIR images from 22 of the 30 patients (73%). The distribution of the increased venous contrast was the same as that of the hypoperfused areas on FAIR images in 16 of these 22. The extent of these lesions was larger than that of lesions visualized by on DWI in 18 of the 22 patients. Hypointense signals reflecting hemorrhage and no increased venous contrast on PSI and hyperperfusion on FAIR images were found in six of the remaining eight patients (20%). Findings on PSI were normal and hypoperfusion areas were absent on FAIR images of two patients (7%).
Increased venous contrast on PSI might serve as an index of misery perfusion and provide useful information.
尽管很少有报告将静脉对比增强区域与灌注变化区域进行比较，但使用磁敏感加权成像在缺血性卒中中静脉对比增强增加已被广泛报道。
比较相位敏感磁共振图像（PSI）上的静脉对比与流动敏感交替反转恢复（FAIR）图像上的灌注变化，并探讨PSI在缺血性卒中中的临床应用。
对30例发病7天内临床怀疑大脑中动脉（MCA）区域急性梗死的患者进行评估。使用3特斯拉扫描仪获得相位敏感成像（PSI）、流动敏感交替反转恢复（FAIR）、扩散加权成像（DWI）和磁共振血管造影（MRA）。两名神经放射科医生独立审查磁共振图像以及PSI、DWI和FAIR图像。他们对临床数据和彼此的发现不知情。在两名神经放射科医生达成共识后最终确定每张图像的异常区域。我们分析了每个病例中PSI上静脉对比增强增加的区域、FAIR图像上的灌注变化以及DWI上的信号变化。
30例患者中有22例（73%）PSI上静脉对比增强增加，FAIR图像上灌注减低明显。这22例中16例静脉对比增强增加的分布与FAIR图像上灌注减低区域相同。这22例患者中有18例这些病变的范围大于DWI显示的病变范围。其余8例患者中有6例（20%）发现反映出血的低信号、PSI上无静脉对比增强增加且FAIR图像上有高灌注。2例患者（7%）的PSI表现正常，FAIR图像上无灌注减低区域。
PSI上静脉对比增强增加可能作为灌注不良的指标并提供有用信息。
