| Background: Artery stenosis or occlusion caused by atherosclerosis is one of the major causes of ischemic cerebrovascular disease.The middle cerebral artery is the most frequently affected artery of intracranial arterial stenosis caused by atherosclerosis.Because of the wide range of blood supply areas of MCA,the symptoms of cerebral ischemia caused by stenosis or occlusion of MCA are varied.The degree of neurologic impairment varies from asymptomatic cerebral infarction and transient ischemic attack to life-threatening large cerebral infarction.Bring great mental pressure and economic burden to patients and their families.At present,the relationship between intracranial artery stenosis or occlusion and the changes of cerebral perfusion is a hotspots at home and abroad.Most scholars believe that the clinical symptoms and prognosis of patients with intracranial artery stenosis or occlusion are affected not only by the degree of vascular stenosis,but also closely related to the compensatory level of cerebral bloo d flow after collateral circulation.The purpose of this study was to evaluate the cerebral blood flow perfusion level and reserve in patients with MCA stenosis or occlusion by using arterial spin label perfusion imaging,to explore the relationship between MCA stenosis or occlusion and the changes of cerebral perfusion,and to provide help for the clinical treatment and prognosis of the patients.Objective: The changes of cerebral blood flow perfusion in the main feeding areas of MCA were evaluated by ASL technique.To explore the relationship between the degree of MCA stenosis and the level of cerebral perfusion and the difference of cerebral perfusion between cerebral infarction and TIA patients.Iin order to make a better individualized treatment plan and judge the prognosis in clinic.Methods: Collection of twenty-three patients with ICVD for the first time,including 12 patients with cerebral infarction and 11 patients with TIA.All of them were in accordance with the criteria of inclusion and exclusion.All patients underwent routine craniocerebral magnetic resonance imaging,including T1 weighted imaging,T2 weighted imaging,and diffusion weighted imaging,magnetic resonance angiography confirmed the existence of responsible side MCA stenosis or occlusion and evaluated its degree of stenosis.ASL was used to measure the value of cerebral blood flow in the stenosis side and the healthy side of the blood supply area of MCA,as well as in the anterior watershed area,the posterior watershed area and the ba sal ganglia area.The ratio of the affected side to the healthy side was calculated to evaluate the cerebral blood flow perfusion.All data were processed by SPSS19.0 statistics software,and the significant standard for testing was bilateral test P < 0.05.Results: 1.There was no significant difference in the degree of MCA stenosis or occlusion between cerebral infarction group and TIA group(P > 0.05).2.The CBF values in the anterior watershed,posterior watershed and basal ganglia in cerebral infarction group and TIA group were significantly lower than those in healthy side(P < 0.01).3.Compared with the TIA group,the CBF ratio of the affected side to the normal side decreased significantly in the cerebral infarction group(P < 0.01),especially decreased more significantly in the former watershed area(P < 0.01).4.There was a significant negative correlation between the ratio of CBF and MCA stenosis in cerebral infarction group and TIA group(P < 0.05).Conclusion: 1.Stenosis or occlusion of MCA can lead to the decrease of cerebral blood perfusion volume,the cerebral infarction patients were more obvious than those with TIA,especially in the watershed area,and the degree of stenosis and perfusion volume was significantly negative correlation.2.ASL technique can be used to evaluate cerebral blood perfusion after MCA stenosis or occlusion. |
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