【摘要】：目的:這項(xiàng)研究假設(shè)動(dòng)脈自旋標(biāo)記核磁共振成像技術(shù)在3.0T掃描儀上測(cè)量健康志愿者和周圍血管病患者小腿肌結(jié)扎前后血流灌注方面將是一種可靠無創(chuàng)的技術(shù),并且將對(duì)這兩個(gè)組群進(jìn)行區(qū)分。以往的研究工作證實(shí)了釓對(duì)比劑的首過效應(yīng)在周圍血管病患者小腿肌灌注測(cè)量的實(shí)用性。然而,患有周圍血管病的患者通常會(huì)有進(jìn)展性的腎疾病,所以不能接受釓對(duì)比劑。應(yīng)用動(dòng)脈自旋標(biāo)記測(cè)量小腿肌灌注的一大優(yōu)勢(shì)就是不用釓對(duì)比劑。方法:周圍血管病患者的特征有跛行,踝肱指數(shù)0.4-0.9。正常對(duì)照組年齡要匹配,并且沒有周圍血管病的任何風(fēng)險(xiǎn)因素。收集周圍血管病患者15名,健康對(duì)照者30名。所有受試者都采取仰臥位,并以套袖止血帶進(jìn)行結(jié)扎以達(dá)到缺血后反應(yīng)性充血,在3.0T掃描儀上對(duì)受試者進(jìn)行掃描。掃描后獲得61幅ASL原始圖像,通過運(yùn)動(dòng)矯正后再進(jìn)行信號(hào)平均得到動(dòng)脈自旋標(biāo)記血流量圖。灌注峰值是在ASL血流量圖上最大信號(hào)強(qiáng)度處取ROI測(cè)得,本次研究選取的是比目魚肌的最大血流值。灌注測(cè)量研究是在周圍血管病患者與正常對(duì)照組之間進(jìn)行,而可重復(fù)性研究通過12個(gè)受試者(5個(gè)正常對(duì)照,7個(gè)周圍血管病患者)重復(fù)測(cè)量來完成。結(jié)果:通過對(duì)磁共振成像結(jié)果分析得出30名健康對(duì)照者(年齡,52±10歲)的肌灌注峰值(peak perfusion,PP)為61±13ml/min-100g,15名周圍血管病患者(年齡:63±9歲,踝肱指數(shù):0.68±0.11)的PP值為37±9ml/min-100g,健康對(duì)照組明顯高于周圍血管病患者。兩獨(dú)立樣本T檢驗(yàn)結(jié)果顯示95%的可信區(qū)間不跨0,我們可以認(rèn)為兩組數(shù)據(jù)均值差異具有統(tǒng)計(jì)學(xué)意義,作為可重復(fù)性測(cè)量設(shè)計(jì)的研究結(jié)果顯示,12名受試者測(cè)量前后結(jié)果的組內(nèi)相關(guān)系數(shù)(intraclass correlation coefficient ICC)為0.94,(95%的可信區(qū)間95%confidence interval[CI]:0.80-0.98),對(duì)45名受試者兩位觀察者間的組內(nèi)相關(guān)系數(shù)為0.98%,(95%的可信區(qū)間[CI]:0.96-0.99)。結(jié)論:動(dòng)脈自旋標(biāo)記技術(shù)是一種可重復(fù)性非創(chuàng)傷性的技術(shù)在測(cè)量小腿肌灌注方面。動(dòng)脈自旋標(biāo)記技術(shù)可以對(duì)正常人群與周圍血管病患者進(jìn)行辨別。這項(xiàng)科技會(huì)證實(shí)它在提高肌灌注臨床治療方案上的作用,特別是對(duì)于那些不能接受釓對(duì)比劑的患者。
[Abstract]:Objective: this study hypothesized that arterial spin-labeled magnetic resonance imaging would be a reliable and noninvasive technique for measuring blood perfusion in healthy volunteers and patients with peripheral vascular disease before and after ligation of the leg muscles on a 3.0T scanner. And the two groups will be distinguished. Previous studies have confirmed the usefulness of the first-pass effect of gadolinium contrast agents in the measurement of leg muscle perfusion in patients with peripheral angiopathy. However, patients with peripheral vascular disease usually have progressive kidney disease, so gadolinium contrast agents are not acceptable. One advantage of using arterial spin labeling to measure leg muscle perfusion is the use of gadolinium contrast agents. Methods: the features of peripheral vascular disease were claudication, ankle brachial index (malleolus index) 0.4-0.9. Normal controls are age-matched and have no risk factors for peripheral vascular disease. Fifteen patients with peripheral vascular disease and 30 healthy controls were collected. All subjects were supine and ligated with cuff tourniquet to achieve reactive hyperemia after ischemia. The subjects were scanned on 3.0T scanner. After scanning, 61 original ASL images were obtained. The peak value of perfusion was obtained from ROI at the maximum signal intensity on ASL blood flow chart, and the maximum blood flow value of soleus muscle was selected in this study. Perfusion measurements were performed between peripheral vascular disease patients and normal controls, while repetitive studies were performed by repeated measurements in 12 subjects (5 normal controls and 7 peripheral vascular disease patients). Results: the peak muscle perfusion (peak perfusion,PP) of 30 healthy controls (age, 52 鹵10 years) was 61 鹵13 ml / min -100 g / g of peripheral vascular disease (age: 63 鹵9 years). The malleolus brachial index (PP) was 37 鹵9 ml / min ~ (-100 g), which was significantly higher in the healthy control group than in the peripheral vascular disease patients. The results of T test of two independent samples show that 95% confidence interval is not over 0. We can think that the difference of mean value between two groups of data is statistically significant, as a result of repeatable measurement design, The intragroup correlation coefficient (intraclass correlation coefficient ICC) of 12 subjects before and after measurement was 0.94 (95% confidence interval 95%confidence interval [CI]: 0.80-0.98). The correlation coefficient between two observers in 45 subjects was 0.98 (95% confidence interval [CI]: 0.96-0.99). Conclusion: arterial spin labeling is a reproducible non-traumatic technique for measuring leg muscle perfusion. Arterial spin labeling can distinguish normal people from patients with peripheral vascular disease. The technology will confirm its role in improving clinical treatment of muscle perfusion, especially in patients who cannot accept gadolinium contrast.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R543.5

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 鄭罡;王利;趙鐵柱;李強(qiáng);潘之穎;盧光明;;動(dòng)脈自旋標(biāo)記技術(shù)及其衍生技術(shù)[J];生物物理學(xué)報(bào);2012年12期

2 倪萍;張英魁;史凱寧;趙希剛;王小燕;吳博;陳自謙;;全腦3D動(dòng)脈自旋標(biāo)記成像及其在顱內(nèi)腫瘤病變中的應(yīng)用[J];中國(guó)醫(yī)療設(shè)備;2013年10期

3 霍英松;周海燕;;動(dòng)脈自旋標(biāo)記在成人中樞神經(jīng)系統(tǒng)疾病中的應(yīng)用[J];實(shí)用臨床醫(yī)學(xué);2014年02期

4 霍英松;周海燕;;動(dòng)脈自旋標(biāo)記在小兒中樞神經(jīng)系統(tǒng)檢查中的應(yīng)用[J];實(shí)用臨床醫(yī)學(xué);2014年03期

5 黃浩哲;李文濤;;動(dòng)脈自旋標(biāo)記技術(shù)的研究進(jìn)展[J];中國(guó)癌癥雜志;2013年11期

6 王建偉;施海彬;劉圣;王敏;魯珊珊;祖慶泉;;反轉(zhuǎn)恢復(fù)時(shí)間對(duì)動(dòng)脈自旋標(biāo)記技術(shù)腦灌注成像的影響[J];江蘇醫(yī)藥;2012年06期

7 王利;鄭罡;趙鐵柱;郭超;李林;盧光明;;動(dòng)脈自旋標(biāo)記技術(shù)在腦部疾病中的臨床應(yīng)用[J];生物醫(yī)學(xué)工程學(xué)雜志;2013年01期

8 朱記超;婁明武;張方t，

本文編號(hào)：2342165