脑侧支循环的评估.ppt

第一行为增强前ct扫描图，可见右侧大脑中动脉高密度征，岛帶征，豆状核轮廓模糊等早期征象； 第二行为动脉早期，可见右侧mca血管分布区增强信号减少； 第三行动脉中期，对应区域大脑中动脉充盈缺损； 第四行动脉晚期，可见持续低密度区域，大白箭头指向严重灌注缺失区，小白箭头指向中度灌注缺失。 * Liebeskind DS: Imaging the future of stroke: I. Ischemia. Ann Neurol 2009; 66: 574–590. 28 * Stroke. 2004 Jun;35(6):1345-9. Epub 2004 Apr 29. Recurrent stroke in patients with symptomatic carotid artery occlusion is associated with high-volume flow to the brain and increased collateral circulation. Rutgers DR1, Klijn CJ, Kappelle LJ, van der Grond J. * SNR abbr.Signal Noise Ratio 信噪比，信号噪声比;? 特定吸收率specific absorption rate, SAR * Kambiz Nael, Arash Meshksar, David S. Liebeskind, Bruce M. Coull, Elizabeth A. Krupinski and J. Pablo Villablanca，Quantitative Analysis of Hypoperfusion in Acute Stroke: Arterial Spin Labeling Versus Dynamic Susceptibility Contrast，Stroke. 2013;44:3090-3096 DSC 动态磁敏感对比增强 * * 早期FADS图与晚期FADS图叠加就相当于CBV图。 右侧MCA闭塞，绿色箭头代表梗死区域，黄色箭头代表非梗死区域，TTP延长，CBF下降／CBV升高，在晚期FADS图上也有类似的改变。 occlusion. The infarct (green arrow) appears as a region of reduced intensity on all but the time-to-peak (TTP) and diffusion-weighted images (DWI) where values are increased. The perfusion-weighted abnormality (shown outlined on the diffusion-weighted image) corresponds to the right MCA territory. The late factor analysis of dynamic studies (FADS) image shows increased intensity in the noninfarcted portion of the MCA territory (yellow arrow) and the cerebral blood volume (CBV) and cerebral blood flow (CBF) values that are higher than in the infarcted region. 1、Perfusion MRI of infarcted and noninfarcted brain tissue in stroke: a comparison of conventional hemodynamic imaging and factor analysis of dynamic studies. Martel AL1, Allder SJ, Delay GS, Morgan PS, Moody AA. Invest Radiol. 2001 Jul;36(7):378-85. 2、 Oh Young Bang, MDa ; Kwang Ho Lee, MDa ; Suk Jae Kim, MDa ; David S. Liebeskind, MDb. Benign Oligemia Despite a Malignant MRI Profile in Acute Ischemic Stroke. J Clin Neurol 2010;6:41-45 * 一些短寿命的物质（如18F，11C等），在衰变过程中释放出正电子，一个正电子在行进十分