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目的探讨MR灌注加权成像(perfusion weighted imaging,PWI)在肝豆状核变性(hepatolenticular degener-ation,HLD)诊断中的应用价值。资料与方法对30例临床诊断为HLD的患者及对照组25例行常规颅脑MRI,以及注射对比剂(Gd-DTPA)后采用自旋回波-回波平面成像(SE-EPI)序列MRPWI检查。通过工作站重组相对局部脑血容量(rCBV)图、局部脑血流量(rCBF)图及对比剂平均通过时间(rMTT)图。计算每例受试者的豆状核及丘脑等HLD患者脑病变易发区域的rCBV、rCBF及rMTT相对值,比较HLD患者组和对照组之间的rCBV、rCBF及rMTT相对值差别。结果常规MRI异常信号(多为长T1、长T2信号)最常见于HLD患者的豆状核及丘脑等部位。PWI显示HLD患者组的rCBV、rCBF均值较对照组低。结论MR脑血流灌注图和半定量分析有助于观察HLD患者病变区的血流动力学改变,与常规MRI结合可同时反映HLD患者脑病变的部位、形态和功能变化。
Objective To investigate the value of MR perfusion weighted imaging (PWI) in the diagnosis of hepatolenticular degena-tion (HLD). Materials and Methods Twenty-five patients with clinical diagnosis of HLD and control group underwent routine cranial MRI and Gd-DTPA injection, and then analyzed by MRPWI using spin echo-echo planar imaging (SE-EPI) . The relative local cerebral blood volume (rCBV) maps, regional cerebral blood flow (rCBF) maps and mean contrast time (rMTT) maps were reconstructed by workstation. The rCBV, rCBF and rMTT relative values of edema and cerebrospinal fluid in patients with HLD such as lentiformis and thalamus were calculated. The relative differences of rCBV, rCBF and rMTT between HLD patients and controls were compared. Results Conventional MRI abnormal signals (mostly long T1 and long T2 signals) were the most common in patients with HLD such as lentiform nucleus and thalamus. PWI showed that the rCBV and rCBF in HLD patients were lower than those in control group. Conclusions MR perfusion maps and semi-quantitative analysis are helpful to observe the hemodynamic changes in the lesion area of patients with HLD. Combined with conventional MRI, the location, shape and function of brain lesions in HLD patients can be reflected.