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目的:探讨基线表观扩散系数(ADC)阈值的超急性期图预测亚急性期脑卒中梗死体积与异常弥散加权成像(DWI)体积差异。方法:选取2014年10月至2016年6月在我院治疗的急性缺血性脑血管病患者105例,进行基线(<6 h)和亚急性期DWI及常规磁共振成像(MRI)序列扫描。在基线DWI图像上,分别测定缺血中心、影像半暗带及相应对侧正常脑组织ADC值,并计算相对ADC值(rADC),将影像半暗带r ADC值设定为ADC阈值。结果:缺血中心区与影像半暗带的ADC值均较对侧正常区ADC值下降,差异有统计学意义(P<0.05);缺血中心区ADC值为(530.37±77.50)10~(-6)mm~2,明显低于影像半暗带,差异有统计学意义(P<0.05);缺血中心r ADC值为(0.611±0.105),明显低于影像半暗带区,差异有统计学意义(P<0.05);基线ADC图异常区域体积为13.25(4.72~24.80)cm~3,与基线DWI异常区域体积以及液体衰减反转恢复序列(FLAIR)梗死体积比较差异无统计学意义(P>0.05);ADC图异常区域体积与FLAIR梗死体积呈正相关(r=0.920,P<0.05),DWI异常区域体积与FLAIR梗死体积呈正相关(r=0.911,P<0.05)。结论:基于ADC阈值的超急性期ADC图异常区域体积与梗死体积有较好的一致性,具有一定的预测价值。
OBJECTIVE: To explore the hyperbaric phase diagram of baseline apparent diffusion coefficient (ADC) threshold to predict the volume difference between subacute cerebral infarction volume and abnormal diffusion-weighted imaging (DWI). Methods: A total of 105 patients with acute ischemic cerebrovascular disease treated in our hospital from October 2014 to June 2016 were enrolled. Baseline (<6 h) and subacute DWI and conventional magnetic resonance imaging (MRI) scans . On the baseline DWI images, the ADC value of the ischemic center, the image penumbra and the corresponding contralateral normal brain tissue were respectively measured and the relative ADC value (rADC) was calculated. The rCP value of the penumbra was set as the ADC threshold value. Results: The ADC values in the ischemic center and the penumbra were significantly lower than those in the normal contralateral side (P <0.05). The ADC value in the ischemic center was (530.37 ± 77.50) 10 ~ ( -6) mm ~ 2, which was significantly lower than that in the penumbra (P <0.05). The r ADC value in the ischemic center was (0.611 ± 0.105), which was significantly lower than that in the penumbra (P <0.05). The abnormal area volume of baseline ADC was 13.25 (4.72 ~ 24.80) cm ~ 3, which was not significantly different from baseline DWI volume and FLAIR volume (P> 0.05). There was a positive correlation between the volume of abnormal ADCA area and the infarct volume of FLAIR (r = 0.920, P <0.05). The volume of abnormal area of DWI was positively correlated with the volume of FLAIR infarction (r = 0.911, P <0.05). Conclusion: There is a good agreement between the abnormal area volume and the infarct volume based on the ADC threshold value of hyperacute phase ADC map, which has some predictive value.