临床核磁弥散成像不匹配对预测缺血半暗带价值.pdfVIP

20074 9 4 ChinJ Geriatr Heart BrainVessel Dis,Apr 2007,Vol 9, o.4 247 1 1 1 1 1 2 2 廖晓凌, 王伊龙 , 王拥军,薛静 , 高培毅 , 刘梅丽,于兰 ( 1., 100050; 2., 300060) : 目的 探讨急性缺血性脑卒中超早期临 核磁弥散成像不匹配(clinica-l diffusion mismatch,CDM) 对预测缺血半 暗带的价值方法 选择在超早期( 发病6 h 内) 完成急诊核磁检查的大脑中动脉供血区脑梗死患者78 例,在核磁 检查前完成美国国立卫生研究院脑卒中量表( IHSS) 评分缺血半暗带以核磁灌注加权成像(PWI)-弥散加权成像 ( DWI) 不匹配表示,CDM 定义为 IHSS8 分而DWI 异常体积 25 ml结果 入选的78 例患者中,存在PWI-DWI 不匹配者为63 例,存在CDM 者为28 例, CDM 预测PWI-DWI 不匹配的特异度为86.7%, 阳性预测值为92.9%, 但灵 敏度仅为41.3% 一致性检验的Kappa 值为0. 148结论 急性缺血性脑卒中超早期CDM 预测缺血半暗带有较高 的特异度和阳性预测值, 可作为筛选溶栓患者的工具之一 :脑血管意外; 磁共振成像;脑缺血; 预测 :R743.3 :A : 1009-0126(2007)04-0247-03 The value of clinica-l diffusion mismatch for predicting the ischemic penumbra LIAO Xiao-ling, WA G Y-i long, WA G Yong-jun, et al ( Dep artment of Neurology , B eji ing Tiantan Hosp ital , Cap ital University of Med ical Sciences , Beij ing 100050, China) Abstract: Objective To evaluate the value of mismatch between stroke severity, assessed with the ational Institutes of Health Stroke Scale ( IHSS) , and the volume of the diffusion-weighted imaging (DWI) lesion (clinica-l diffusion mismatch, CDM) for predicting the ischemic penumbra represented by mismatch between perfusion-weighted imaging (PWI) and DWI. Methods A total of 78 patients with acute cerebral infarcts within themiddle cerebral artery territory and examined by MRIwithin 6hours of symptom onsetwere prospec- tively studied. MRI including MRA, DWI and PWI sequences was performed on admission. IHSS was ob- tained just before MRIwas performed.CDM was defined as IHSS 8 and DWI lesion volume 25m