【作者】 王秀河；

【导师】 黄耀熊； 黄力；

【作者基本信息】 暨南大学 ， 生物医学工程， 2006， 博士

【摘要】 目的： 研究磁共振弥散加权成像(diffusion-weighted imaging，DWI)和灌注加权成像(perfusion-weighted imaging，PWI)技术，对早期脑梗死(发病时间≤24h)的诊断以及在判断缺血半暗带演变中的价值。具体为探讨：早期脑梗死患者在MTT(mean transit time)和CBV(cerebral blood volume)图上的不同表现；MTT-DWI、CBV-DWI不匹配程度对预测梗死灶增大程度及最终脑梗死区大小的作用；ADC、rCBV及MTT比值对缺血半暗带的诊断价值；DWI、PWI在二维质子磁共振波谱成像技术(2D hydrogen proton magnetic resonance spectroscopy imaging，2D ~1H-MRSI)及磁共振血管成像(MR angiography，MRA)技术协助下，对早期脑梗死病变位置作准确显示及对缺血半暗带及脑损伤程度的作较为准确判断，并用于对急性脑梗死患者行急诊血管内支架治疗的可能性。 材料与方法： 本研究包括42例早期脑梗死患者(超急性期6例，急性期36例)，男22例，女20例，年龄为36-80岁，平均54.60岁。42例共进行88次常规MRI及DWI检查，其中30例(除一例发病3h的患者接受静脉溶栓治疗，其余29例均未接受溶栓治疗)共进行35次PWI及76次MRA检查，21例共进行23次2D-~1H MRSI检查，其中9例患者同时进行11次常规MRI、DWI、PWI、2D-~1HMRSI及MRA检查。一例患者接受血管内支架治疗，并对治疗前后的灌注情况进行比较。 扫描完成后，使用functool软件包后处理获得表观弥散系数(Apparent更多还原

【Abstract】 Purpose of the study:To study the roles of isotropic diffusion weighted imaging(DWI) and perfusion weighted imaging(PWI) in diagnosing early cerebral infarction(the time after onset of stroke: ≤24 hours), and in monitoring the development of cerebral ischemic penumbra. The major investigations including: evaluate the differences in cerebral perfusion seen on mean transit time(MTT) and cerebral blood volume(CBV) maps and to assess the subsequent prognostic value of the MTT-DWI and CBV-DWI mismatch in the first day of infarction on lesion enlargement and in predicting final infarct size; evaluate the roles of rADC, rMTT and rrCBV in determining the ischemic penumbra; investigate the roles of DWI and PWI with the help of the techniques of 2D hydrogen proton magnetic resonance spectroscopy imaging(2D ~1H-MRSI) and MR angiography(MRA), in diagnosing early cerebral infarction and in the endovascular stent-assisted angioplasty treatment for patients with acute stroke. Material and Methods:42 cases (6 hyperacute,36 acute) were studied, including 22 male and 20 female, ages from 36 to 80 years old and mean 54.60 years old. 88 work-ups of 42 patients were imaged with conventional MRI and single-shot echo-planar isotropic diffusion weighted imaging. Among the patients, 35 PWI and 76 MRA were performed successfully in 30 persons(Only one patient received更多还原