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DWI体积差异分析-现代医学

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DWI体积差异分析

单位：1. 上海市浦东新区人民医院放射科, 上海 201299;
2. 上海市浦东新区人民医院神经内科, 上海 201299

分类号：R743.3;R445.2

出版年·卷·期（页码）：2017·36·第三期（324-327）

摘要：

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rADC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^-6mm²，明显低于影像半暗带，差异有统计学意义（P<0.05）；缺血中心rADC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） cm³，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 investigate difference of infarct volume prediction of ADC map of the super acute stage based on the apparent diffusion coefficient (ADC) threshold in subacute phase of cerebral infarction and the volume of abnormal diffusion weighted imaging (DWI). Methods: Selected 105 cases of acute ischemic cerebrovascular disease treated in our hospital from October 2014 to June 2016, DWI and routine MRI scan were performed at baseline (<6 h) and subacute stage.On baseline DWI images, measured the ADC value of the ischemic center, the image semi dark zone and the corresponding contralateral normal brain tissue, and calculated the relative ADC value (rADC), and the rADC value of the image was set to ADC threshold. Results: The ADC value of the ischemic central area and the image of the semi dark zone was lower than that of the normal ADC value, and the difference was statistically significant (P<0.05); ischemic central area ADC value was(530.37±77.50)10^-6mm², it was significantly lower than image semi dark zone, the difference had statistical significance (P<0.05); the central ischemic rADC value was(0.611±0.105), it was significantly lower than the image semi dark zone, the difference had statistical significance (P<0.05);Baseline ADC abnormalities regional volume was 13.25(4.72~24.80) cm³, compared with baseline DWI abnormal region volume and fluid-attenuated inversion recovery (FLAIR) infarct volume,the difference were not statistically significant (P>0.05). The abnormal regional volume of ADC map was positively correlated with the infarct volume of FLAIR (r=0.920, P<0.05). The abnormal regional volume of DWI was positively correlated with the infarct volume of FLAIR (r=0.911, P<0.05). Conclusion: Abnormal regional volume of ADC map in super acute stage based on ADC threshold is good agreement with the infarct volume, has a certain predictive value.

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