| Objectives To explore the effect of three-dimensional arterial spin labeling technique(3D-ASL)on the value of cerebral blood flow(CBF)in different age groups by multipost label delay time(PLD),to help clinicians select appropriate PLD;to explore the relationship between posterior cerebral artery types and early posterior circulation perfusion,and to provide basis for the differential diagnosis of physiological hypoperfusion and ischemic cerebrovascular disease;to explore the value of 3D-ASL in the diagnosis of acute lacunar infarction.Methods 135 healthy volunteers,aged 20~80 years,66 males and 69 females,according to the age of WHO,the subjects were divided into youth group [45 subjects,aged 20~44 years,mean(30.8±6.3)years],middle-aged group [44 subjects,aged 45~59 years,mean(50.2±5.8)years],elderly group [46 subjects,aged 60~80 years,mean(68.7±7.3)years].Magnetic resonance angiography was performed in 135 healthy volunteers,the CBF of brain tissue(frontal cortex,frontal cortex,parietal cortex,parietal cortex,temporal cortex,temporal cortex,occipital cortex,occipital cortex,brainstem,cerebellar hemisphere,lenticular nucleus,internal capsule,thalamus)were measured with PLD1.5s,PLD2.0s and PLD2.5s;to explore the development type of bilateral posterior cerebral arteries and measure the CBF value of the circulation blood supply area with PLD1.5s and PLD2.5s,and analyze the relationship between the development of the posterior circulation and the perfusion level of the responsible area;73 patients with acute lacunar infarction were included in the study,to observe and compare the relationship between 3D-ASL and diffusion-weighted imaging(DWI)and the condition of large vessels in head and neck.Results 1 The CBF value of brain tissue in the young group was significant different(P<0.05)except for the temporal cortex in different PLDs,pairwise comparison in CBF group: there were significant difference between PLD2.5s and PLD2.0s in the internal capsule,frontal cortex,thalamus and parietal cortex(P<0.05),but no significant difference between PLD2.0s and PLD1.5s(P>0.05),and there was significant difference between PLD2.0s and PLD1.5s(P<0.05),PLD2.0s was the relative highest perfusion,PLD2.5s and PLD1.5s were the relative lowest perfusion;there were significantly different among PLD2.5s,PLD2.0s and PLD1.5s in brainstem and parietal white matter(P<0.05),PLD2.0s was the highest perfusion and PLD1.5s was the lowest;there was no significant difference between PLD2.5s and PLD2.0s(P>0.05)in frontal white matter,temporal white matter,lenticular nucleus,cerebellum,occipital cortex,occipital white matter,but there was significant difference between PLD2.5s and PLD1.5s(P<0.05),PLD2.0s and PLD2.5s were the relative highest perfusion,PLD1.5s was the relative lowest perfusion.The CBF value of brain tissue in the middle-aged group was statistically significant(P<0.05)except for the parietal cortex in different PLDs,pairwise comparison in CBF group: there were significant difference between PLD2.5s and PLD2.0s in lenticular nucleus,frontal white matter,parietal white matter(P<0.05),but no significant difference between PLD2.5s and PLD1.5s(P>0.05),and there was significant difference between PLD2.0s and PLD1.5s(P<0.05),PLD2.0s was the relative highest perfusion,and PLD2.5s and PLD1.5s were the relative lowest perfusion;there were significantly different among PLD2.5s,PLD2.0s and PLD1.5s in internal capsule(P<0.05),PLD2.0s was the highest perfusion and PLD1.5s was the lowest perfusion;there was no significant difference between PLD2.5s and PLD2.0s(P>0.05)in frontal white matter,temporal white matter,lenticular nucleus,cerebellum,occipital cortex,occipital white matter,but there was significant difference between PLD2.5s and PLD1.5s(P<0.05),PLD2.0s and PLD2.5s were the relative highest perfusion,PLD1.5s was the relative lowest perfusion.The CBF value of brain tissue in the elderly group was significant difference at all different PLD(P<0.05),pairwise comparison in CBF group: there were significantly different among PLD2.5s,PLD2.0s and PLD1.5s in frontal cortex,lenticular nucleus,cerebellum,occipital white matter,parietal cortex and parietal white matter,PLD2.5s was the highest perfusion and PLD1.5s was the lowest;there was no significant difference between PLD2.5s and PLD2.0s(P>0.05)in frontal white matter,temporal cortex,temporal white matter,internal capsule,thalamus,brainstem,occipital cortex,but there was significant difference between PLD2.5s and PLD1.5s(P<0.05),PLD2.0s and PLD2.5s were the relative highest perfusion,PLD1.5s was the relative lowest perfusion.2 The CBF value of the early posterior circulation in the variant side of unilateral embryonic posterior cerebral artery volunteers was higher than that in the normal developing side,with statistical significance(P<0.05),but there was no significant difference in CBF between the two sides in the late period(P>0.05);there was no significant difference in CBF between the left and right posterior circulation in the early and late stages(P>0.05),and there was no significant difference in CBF between the early and late stages(P>0.05);there was no significant difference in CBF value between the left and right posterior circulation in the early and late stages(P>0.05),but there was significant difference in CBF value between the early and late stages(P<0.05);the CBF value of the early posterior circulation of bilateral embryonic posterior cerebral artery volunteers was higher than that of bilateral normal developing posterior cerebral artery volunteers,the difference was statistically significant(P<0.05),but there was no significant difference between the two groups in the late period(P>0.05).3 In 73 patients with acute lacunar infarction,58 cases of 3D-ASL low perfusion area were close to or smaller than DWI high signal area(without ischemic penumbra),47 cases of MRA indicated that there was no obvious stenosis or occlusion of head and neck big blood vessels;15 cases of 3D-ASL low perfusion area was significantly larger than DWI high signal area(ischemic penumbra),12 cases of MRA indicated that there was obvious stenosis or occlusion of head and neck big blood vessels.There was a significant difference in the probability of head and neck macroangiopathy between the patients with and without ischemic penumbra(P<0.05).Conclusions 1 PLD2.0s can be used in young and middle-aged patients to reflect the final perfusion results and PLD2.5s can be used in elderly patients,PLD1.5s can be used in all age groups to observe the abnormal vascular behavior.2 The early perfusion value of normal developing posterior cerebral artery is lower than that of embryonic posterior cerebral artery.3 Patients with acute lacunar infarction with ischemic penumbra may be caused by macrovascular lesions.Figure 16;Table 10;Reference 109... |
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