de Havenon A, Sultan-Qurraie A, Tirschwell D, Cohen W, Majersik J, Andre J B
From the Department of Neurology (A.d.H., J.M.), University of Utah, Salt Lake City, Utah.
Departments of Neurology (A.S.-Q., D.T.).
AJNR Am J Neuroradiol. 2015 Dec;36(12):2292-5. doi: 10.3174/ajnr.A4444. Epub 2015 Sep 3.
Hypoxic-ischemic encephalopathy carries an uncertain prognosis. We sought to retrospectively assess the prognostic value of arterial spin-labeling MR imaging in 22 adult patients diagnosed with hypoxic-ischemic encephalopathy. Quantitative CBF maps were generated from the M0 map, and arterial spin-labeling data on a per-voxel basis were regionally interrogated via visual inspection and ROI placement. Hyperperfusion was defined as regional increases in CBF of >20% (relative to global CBF) and/or >100 mL/100 g/min. Eleven of 22 patients had prominent bilateral medial occipital lobe hyperperfusion, all of whom died before hospital discharge. One patient who had nondistinct arterial spin-labeling hyperperfusion and restricted diffusion survived. Medial occipital lobe hyperperfusion is a distinctive pattern that merits prospective investigation in a cohort of patients with moderate hypoxic-ischemic encephalopathy to determine its predictive ability in patients with a higher likelihood of survival.
缺氧缺血性脑病的预后不确定。我们试图回顾性评估动脉自旋标记磁共振成像对22例诊断为缺氧缺血性脑病的成年患者的预后价值。从M0图生成定量脑血流量图，并通过视觉检查和感兴趣区放置对每个体素的动脉自旋标记数据进行区域分析。高灌注定义为脑血流量区域增加>20%（相对于全脑血流量）和/或>100 mL/100 g/min。22例患者中有11例双侧枕叶内侧明显高灌注，所有这些患者均在出院前死亡。1例动脉自旋标记高灌注不明显且弥散受限的患者存活。枕叶内侧高灌注是一种独特的模式，值得在一组中度缺氧缺血性脑病患者中进行前瞻性研究，以确定其对生存可能性较高患者的预测能力。
