摘要
目的：探讨MR扩散系数值对急性脑梗死继发出血（HT）预测的价值。方法：75只兔颈内动脉注射自体血栓制作急性脑梗死模型，证实脑梗死的动物在3.0T MR设备上依次行3、6、12、24、48及72h扩散加权成像（DWI），获得表观扩散系数（ADC）图及指数扩散系数（EDC）图。采用欧洲急性中风合作研究方法（ECASS）对病理证实的HT进行分型，包括无HT组与HT组，后者又分为斑点状出血组（HI）及较大出血组（PH）。应用SPSS 11.5统计学软件比较无HT组与不同程度HT组之间ADC及EDC值有无差异。结果：59只（78.67%）动物模型制作成功，其中无HT组21只（35.59%，21/59）、HI组31只（52.54%，31/59）、PH组7只（11.87%，7/59）。无HT组3~72h梗死区ADC值为（0.601±0.128）×10-3~（0.813±0.060）×10-3，HT组ADC值为（0.432±0.091)×10-3~（0.618±0.060）×10-3，各时间点两组ADC值差异均有统计学意义（t值为2.417~5.986，P值为0.000~0.031）。无HT组3~72h梗死区EDC值为（0.415±0.039）~（0.502±0.009），HT组EDC值为（0.559±0.040）~（0.583±0.064），两组各时间点EDC值差异均有统计学意义（t值为4.002~6.995，P值为0.000~0.002）。HI组3~72h梗死区ADC值为（0.435±0.091）×10-3~（0.631±0.045）×10-3，PH组ADC值为（0.390±0.180）×10-3~（0.586±0.104）×10-3，除24h（t值为4.664，P=0.002）外，其余时间点HI组与PH组ADC值均无统计学差异（t值为0.057~1.996，P值为0.171~0.956）。HI组3~72h梗死区EDC值为（0.545±0.039）~（0.638±0.042），PH组EDC为（0.575±0.054）~（0.649±0.019），各时间点两组间EDC值无明显统计学差异（t值为0.051~1.698，P值0.150~0.960）。结论：脑梗死急性期ADC值及EDC值变化与HT的发生存在着相关性，ADC值下降及EDC值增高有可能预测HT的出现，但仅根据扩散系数值不能预测HT的程度。
Abstract
Objective: To investigate the value of diffusion weighted imaging(DWI) in predicting the hemorrhagic transformation(HT) after acute experimental cerebral infarction. Methods: Autologous thrombus was injected into unilateral internal carotid arteries of 75 rabbits to set up acute cerebral infarction model. These rabbits underwent DWI with 3.0T MR equipment at 3, 6, 12, 24, 48 and 72h after arterial occlusion. Apparent diffusion coefficient(ADC) and exponent diffusion coefficient(EDC) map were calculated at work station by using software of function. According to the method of European cooperative acute stroke study(ECASS), the HT of infarcted animals were classified into non-HT and HT groups, the latter was further divided into hemorrhagic infarction(HI) group and parenchymal hematoma(PH) group. The difference of ADC and EDC between non-HT group and various HT groups were assessed by using SPSS 11.5 software. Results: Cerebral ischemic model was successfully set up in 59 rabbits(78.67%). No pathologic findings of HT was found in 21 animals(35.59%, 21/59). Thirty-eight rabbits(64.41%, 38/59) who had HT included 31 rabbits(52.54%, 31/59) with HI and 7(11.87%, 7/59) with PH. The ADC value of non-HT groups and HT group were (0.601±0.128)×10-3~(0.813±0.060)×10-3 and (0.432±0.091)×10-3~(0.618±0.060)×10-3 respectively. There was obvious difference of ADC value between the two groups from 3h to 72h after occlusion(t=2.417~5.986, P=0.000~0.031). Similarly, significant difference of EDC value was found between the non-HT group[(0.415±0.039)~(0.502±0.009)] and HT rabbits[(0.559±0.040)~(0.583±0.064)](t=4.002~6.995, P=0.000~0.002). However, no obvious difference of ADC value was detected between HI group[(0.435±0.091)×10-3~(0.631±0.045)×10-3] and PH group[(0.390±0.180)×10-3~(0.586±0.104)×10-3](t=0.057~1.996, P=0.171~0.956) at every time point, except at 24h(t=4.664, P=0.002). There was no prominent difference of EDC value between HI[(0.545±0.039)~(0.638±0.042)] and PH groups[(0.575±0.054)~(0.649±0.019)](t=0.051~1.698, P=0.150~0.960). Conclusion: There is correlation between the decrease of ADC, the increase of EDC and the occurrence of HT in acute cerebral infarction. The abnormalities of ADC and EDC can probably predict HT. But DWI may play little role in the discrimination between HI and PH.
关键词
脑梗塞 /
脑出血 /
磁共振成像 /
弥散
Key words
Brain infarction /
Cerebral hemorrhage /
Diffusion magnetic resonance imaging
全冠民;袁 涛;魏志刚;刘怀军;尚 华;高国栋;雷建明;李彩英;耿左军.
超高场MR扩散系数值对兔急性脑梗死后出血的预测价值[J]. 中国临床医学影像杂志. 2009, 20(4): 250-254
QUAN Guan-min;YUAN Tao;WEI Zhi-gang;LIU Huai-jun;SHANG Hua;GAO Guo-dong;LEI Jian-ming;LI Cai-ying;GENG Zuo-jun.
Value of ADC and EDC at 3.0T in predicting hemorrhagic transformation after acute experimental cerebral infarction[J]. Journal of China Clinic Medical Imaging. 2009, 20(4): 250-254
中图分类号：
Ｒ743.33
Ｒ743.34
Ｒ445.2
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