Department of Radiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Brain Behav. 2020 Sep;10(9):e01732. doi: 10.1002/brb3.1732. Epub 2020 Aug 7.
High-resolution magnetic resonance imaging (HR-MRI) has high spatial resolution and can simultaneously perform wall and lumen imaging. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can evaluate the integrity of the blood-brain barrier. In this paper, the result of 3.0T HR-MRI and 3.0T DCE-MRI has been evaluated to explore the application value of unilateral middle cerebral artery inflammatory stenosis and changes in vascular permeability parameters of stroke events.
Thirty-six cases of neurological suspicion of central nervous system vasculitis of our hospital were selected from 20 January 2018 to 1 January 2019, who were diagnosed as unilateral middle cerebral artery M1 stenosis/occlusion by 3D TOF MRA. 3.0T HR-MRI and 3.0T DCE-MRI has been applied.
Among the 36 patients who met the inclusion criteria, 23 patients with central nervous system vasculitis were diagnosed. The 23 patients with HR-MRI showed diffuse thickening and enhanced stenosis. The K value of 10/23 patients with acute-subacute cerebral infarction and 3/23 patients in chronic phase were significantly higher than that of the mirror side, and the K value of these patients remeasured in the same region of interest is lower than before after 6 months treatment. The K value in the target area of 10 patients without cerebrovascular events was not statistically significant compared with the mirror side. The K value of patients with acute-subacute cerebral infarction was significantly higher than that without cerebrovascular events (0.098 ± 0.038 vs. 0.007 ± 0.001, p = .000), and there was no significant difference between K in the chronic infarction group and the other two groups (0.098 ± 0.038 vs. 0.044 ± 0.012, p = .058; 0.044 ± 0.012 vs. 0.007 ± 0.001, p = .057).
HR-MRI is an accurate direct imaging method and has a high value for the etiological diagnosis of central nervous system vasculitis. DCE-MRI could be an effective way to evaluate and monitor blood-brain barrier to prevent clinical ischemic stroke.
高分辨率磁共振成像（HR-MRI）具有较高的空间分辨率，可同时进行管壁和管腔成像。动态对比增强磁共振成像（DCE-MRI）可评估血脑屏障的完整性。本文通过评价 3.0T HR-MRI 和 3.0T DCE-MRI 的结果，探讨单侧大脑中动脉炎性狭窄及血管通透性参数改变在脑卒中事件中的应用价值。
选取 2018 年 1 月 20 日至 2019 年 1 月 1 日我院神经内科疑诊中枢神经系统血管炎的患者 36 例，均经三维时间飞跃法磁共振血管成像（3D-TOF-MRA）诊断为单侧大脑中动脉 M1 段狭窄/闭塞，行 3.0T HR-MRI 和 3.0T DCE-MRI 检查。
符合纳入标准的 36 例患者中，最终诊断为中枢神经系统血管炎患者 23 例。23 例 HR-MRI 表现为弥漫性管壁增厚并强化狭窄。10 例急性-亚急性脑梗死和 3 例慢性期患者的 K 值明显高于对侧，且这些患者在同一感兴趣区重复测量的 K 值在治疗 6 个月后低于治疗前。10 例无脑血管事件患者的目标区 K 值与对侧无统计学差异。急性-亚急性脑梗死患者的 K 值明显高于无脑血管事件患者（0.098±0.038 比 0.007±0.001，p=0.000），而慢性梗死组与其他两组之间的 K 值差异无统计学意义（0.098±0.038 比 0.044±0.012，p=0.058；0.044±0.012 比 0.007±0.001，p=0.057）。
HR-MRI 是一种准确的直接成像方法，对中枢神经系统血管炎的病因诊断具有较高的价值。DCE-MRI 可能是评估和监测血脑屏障以预防临床缺血性卒中的有效方法。
