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脑桥交叉性小脑失联络现象在急性缺血性卒中中的扩散张量磁共振研究

Crossed cerebellar diaschisis after acute ischemic stroke detected by intravoxel incoherent motion magnetic resonance imaging.

机构信息

Department of Medical Imaging, The Second Affiliated Hospital of Shandong First Medical University, Taian, 271000, Shandong, China.

School of Basic Medical Sciences, Shandong First Medical University, Taian, 271000, Shandong, China.

出版信息

Neurol Sci. 2022 Feb;43(2):1135-1141. doi: 10.1007/s10072-021-05425-6. Epub 2021 Jul 2.

Abstract

PURPOSE

To study the value of 3.0 T magnetic resonance imaging with intravoxel incoherent motion (IVIM) in the diagnosis of the crossed cerebellar diaschisis (CCD) after the unilateral supratentorial acute ischemic stroke.

METHODS

Seventy-four patients with acute ischemic stroke who underwent intravoxel incoherent motion (IVIM), arterial spin labeling (ASL), and conventional magnetic resonance imaging (MRI) scanning were enrolled. Intravoxel incoherent motion-derived perfusion-related parameters including fast diffusion coefficient (D*), slow diffusion coefficient (D), vascular volume fraction (f), and arterial spin-labeling-derived cerebral blood flow (CBF) of bilateral cerebellum were measured.

RESULTS

In the CCD-positive group, D*, D, and CBF values of the contralateral cerebellum decreased compared with those of the ipsilesional cerebellum (P < 0.05), whereas f significantly increased (P < 0.05). A positive correlation was detected between the slow diffusion coefficient-based asymmetry index (AI-D) and the cerebral blood flow-based asymmetry index (AI-CBF) (r = 0.515, P < 0.01), whereas the vascular volume fraction-based asymmetry index (AI-f) had a negative correlation with the cerebral blood flow-based asymmetry index (AI-CBF) (r =  - 0.485, P < 0.01). Furthermore, the area under the receiver operating characteristic (ROC) curve value of AI-D and AI-f was 0.81 and 0.76, respectively.

CONCLUSIONS

The IVIM is feasible for the detection of CCD. This technique might provide opportunities to further investigate the pathophysiology of CCD.

摘要

目的

研究 3.0T 磁共振体素内不相干运动(IVIM)在单侧幕上急性缺血性脑卒中后交叉性小脑失联络(CCD)诊断中的价值。

方法

纳入 74 例接受 IVIM、动脉自旋标记(ASL)和常规磁共振成像(MRI)扫描的急性缺血性脑卒中患者。测量双侧小脑的 IVIM 衍生灌注相关参数,包括快扩散系数(D*)、慢扩散系数(D)、血管容积分数(f)和动脉自旋标记衍生的脑血流(CBF)。

结果

在 CCD 阳性组中,对侧小脑的 D*、D 和 CBF 值均低于同侧小脑(P<0.05),而 f 值显著增加(P<0.05)。慢扩散系数不对称指数(AI-D)与脑血流不对称指数(AI-CBF)呈正相关(r=0.515,P<0.01),而血管容积分数不对称指数(AI-f)与脑血流不对称指数(AI-CBF)呈负相关(r= -0.485,P<0.01)。此外,AI-D 和 AI-f 的受试者工作特征(ROC)曲线下面积分别为 0.81 和 0.76。

结论

IVIM 可用于检测 CCD。该技术可能为进一步研究 CCD 的病理生理学提供机会。

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