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通过动脉自旋标记磁共振成像无创性检测脑卒中后交叉性小脑 diaschisis。

Crossed cerebellar diaschisis after stroke detected noninvasively by arterial spin-labeling MR imaging.

机构信息

Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 1630 Dongfang Rd, Shanghai, 200127, China.

Department of Radiology, Renji Hospital South Campus, School of Medicine, Shanghai Jiao Tong University, 2000 Jiangyue Rd, Shanghai, 201112, China.

出版信息

BMC Neurosci. 2020 Nov 20;21(1):46. doi: 10.1186/s12868-020-00595-z.

Abstract

BACKGROUND

As a noninvasive perfusion-weighted MRI technique, arterial spin-labeling (ASL) was becoming increasingly used to evaluate cerebral hemodynamics in many studies. The relation between ASL-MRI and crossed cerebellar diaschisis (CCD) was rarely discussed. In this study, the aim of our study was to assess the performance of ASL-MRI in the detection of crossed cerebellar diaschisis after stroke in compared with single-photon emission CT (SPECT).

RESULTS

17 of 51(33.3%) patients revealed CCD phenomenon by the SPECT method. In CCD-positive group, CBF of ipsilateral cerebellar were significantly increased compared with contralateral cerebellar (p < 0.0001) while no significant differences (p = 0.063, > 0.001) in the CCD-negative group. Positive correlation was detected between admission National institute of health stroke scale (NIHSS) and asymmetry index of SPECT (AI) (r = 0.351, p = 0.011), AI (r = 0.372, p = 0.007); infract volume and AI (r = 0.443, p = 0.001), AI (r = 0.426, p = 0.002). Significant correlation was also found between cerebral blood flow of SPECT (CBF) and CBF, AI and AI (r = 0.204, p = 0.04; r = 0.467, p = 0.001, respectively). Furthermore, the area under the receiver operating characteristic (ROC) curve value of AI was 0.829.

CONCLUSIONS

CBF derived from ASL-MRI could be valuable for assessment of CCD in supratentorial stroke patients. Additionally, CCD was significantly associated with larger ischemic volume and higher initial NIHSS score.

摘要

背景

动脉自旋标记(ASL)作为一种非侵入性灌注加权 MRI 技术,在许多研究中越来越多地用于评估脑血流动力学。ASL-MRI 与交叉性小脑失联络(CCD)之间的关系很少被讨论。本研究旨在评估 ASL-MRI 在检测脑卒中后交叉性小脑失联络方面的性能,并与单光子发射 CT(SPECT)进行比较。

结果

SPECT 方法发现 51 例患者中有 17 例(33.3%)存在 CCD 现象。在 CCD 阳性组,对侧小脑的 CBF 明显高于同侧小脑(p<0.0001),而在 CCD 阴性组无明显差异(p=0.063,>0.001)。入院时国立卫生研究院卒中量表(NIHSS)评分与 SPECT 不对称指数(AI)之间存在正相关(r=0.351,p=0.011),AI(r=0.372,p=0.007);梗死体积与 AI(r=0.443,p=0.001)、AI(r=0.426,p=0.002)之间存在正相关。SPECT 的 CBF 与 CBF 之间也存在显著相关性、AI 与 AI(r=0.204,p=0.04;r=0.467,p=0.001)。此外,AI 的 ROC 曲线下面积值为 0.829。

结论

ASL-MRI 衍生的 CBF 可用于评估幕上脑卒中患者的 CCD。此外,CCD 与较大的缺血体积和较高的初始 NIHSS 评分显著相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d60/7678313/9e3af4447545/12868_2020_595_Fig1_HTML.jpg

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