灌注加权成像-弥散加权成像不同匹配与急性脑梗死患者降
纤治疗疗效的关系
刘畅铭;孙井松;黎广宗;陈远芬
【期刊名称】《中华生物医学工程杂志》 【年(卷),期】2017(023)005
【摘要】目的 分析磁共振(MR)灌注加权成像(PWI)-弥散加权成像(DWI)不同匹配与急性脑梗死患者降纤治疗疗效的关系.方法 收集2015年1月至2017年1月本院收治的急性脑梗死患者68例,所有患者均行降纤治疗.患者入院时行PWI、DWI扫描,比较PWI和DWI显示异常的区域范围.治疗前、治疗后7 d采用美国国立卫生研究院卒中量表(NIHSS)进行神经功能缺损评分检查并评价临床疗效.按PWI与DWI显示异常区域范围的匹配情况分为4组:PWI>DWI组(不匹配>20%)、PWI=DWI组(不匹配±20%以内)、PWI DWI匹配情况存在关联(均P<0.05).多元线性回归分析显示,病程(β=-7.146,P=0.016)、入院高血压(β=10.56,P=0.014)、PWI-DWI匹配情况(β=-8.570,P=0.001)是降纤治疗疗效的影响因素.结论 急性脑梗死患者降纤治疗疗效的影响因素较多,PWI-DWI匹配情况可用于预测降纤治疗的疗效.%Objective To investigate the correlation between different matching of magnetic resonance(MR)perfusion weighted imaging(PWI)-diffusion weighted imaging(DWI)and the effect of defibrase in the treatment of acute cerebral infarction. Methods Sixty-eight patients with acute cerebral infarction,who were hospitalized in our hospital between January 2015 and January 2017,were included in the study,and underwent defibrase therapy.All patients underwent PWI and DWI scans at hospitalization, and the abnormal area ranges showed by PWI and DWI were compared. The National Institutes of Health Stroke Scale(NIHSS)was used to determine the neurological deficit score at the baseline and at 7 d after the treatment,and the clinical effect was evaluated.According to matching of the abnormal area ranges showed by PWI and DWI,all patients were divided into 4 groups:PWI>DWI group(no match>20%),PWI=DWI group(mismatch within ± 20%),PWI such as gender,age,smoking,alcohol consumption,hypertension,diabetes,infarction site,basic NIHSS score,duration of disease,combined hyperbaric oxygenation,admission hypertension,admission hyperglycemia,hyperuricemia and PWI-DWI matching. The relationship between NIHSS score decline and various factors at 7 d after the treatment was analyzed.Multivariate linear regression analysis was used to analyze the risk factors influencing the effect of defibrase therapy.Results According to the PWI-DWI matching,68 patients with acute cerebral infarction were divided into the PWI>DWI group(n=38),PWI=DWI group(n=15),PWI group(n=7)and normal group(n=8).There were statistically significant differences in the clinical effect between the 4 groups (χ2=40.32,P<0.05). The clinical effect in the PWI>DWI group was significantly better than that in the PWI the duration of disease(β=-7.146,P=0.016),admission PWI-DWI matching (β=- hypertension(β=10.56,P=0.014)and 8.570,P=0.001)were the risk factors influencing the effect of defibrase therapy. Conclusion There are many risk factors influencing the effect of
灌注加权成像-弥散加权成像不同匹配与急性脑梗死患者降纤治疗疗效的关系
