Evaluation Of Cerebrovascular Reserve And TCM Syndrome Types In Patients With Cerebral Ischemic Lesions By CO₂ Stimulated ASL

Objective 1.Use arterial spin labeling to measure cerebral blood flow in patients with cerebral ischemic lesions,understand the changes of cerebral blood flow,and evaluate the cerebrovascular reserve function of patients with cerebral ischemic lesions by arterial spin labeling combined with CO2 load test.2.To understand the main TCM syndromes of cerebral ischemic lesions,including the type of hyperactivity of liver-yang and the type of obstruction of phlegm-dampness,measure the cerebral blood flow and cerebrovascular reserve function,explore the relationship between different TCM syndromes of cerebral ischemic lesions and cerebrovascular reactivity,and provide objective basis for TCM syndromes of cerebral ischemic lesions.Materials and Methods The patients with clinical cerebral ischemic lesions in The Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine were selected and divided into cerebral ischemic lesions group and control group according to the syndrome differentiation,including 10 patients with hyperactivity of liver yang,10 patients with obstruction of phlegm and dampness,and 10 controls without ischemic lesions.Using GE discovery 750 3.0T magnetic resonance machine,magnetic resonance arterial spin labeling sequence examination was carried out in resting state and CO2 load state in two groups respectively.After examination,ADW4.6 post-processing workstation was used for processing,and ASL-CBF pseudo-color image was automatically generated by Functool software,and Region of Interest(Region of Interest)Interest(ROI)was selected as follows:bilateral superior frontal gyrus,temporal pole,lenticular nucleus and thalamus were used to measure cerebral blood flow(CBF)values,and CBF values before and after CO2 inhalation were measured respectively.Statistical analysis was performed by SPSS 20.0 software after measurement.The CBF values of cerebral ischemic lesion group and control group were compared to understand the cerebrovascular reserve,and the CBF values of hyperactivity of liver-yang syndrome and obstruction of phlegm-dampness syndrome were compared.Result 1.There was no significant difference in CBF values between the bilateral brain regions in the control group without ischemic lesions(p>0.05).The CBF values in each region of the female brain were higher than those in the male,showing a significant difference with statistical significance(p<0.05).There was no significant difference in the CRC values of ROI between the left and right brains of control subjects(p>0.05).2.There was no significant difference in CBF value between ROI of each part of brain on both sides in cerebral ischemic lesion group(p>0.05).Before and after CO2 loading,the CBF value of bilateral superior frontal gyrus in women was higher than that in men,with statistical significance(p<0.05).There was no significant difference in the CRC values of ROI between left and right brains(p>0.05).3.There was no significant difference in CBF value between the cerebral ischemic lesion group and the control group without ischemic lesion before and after CO2 inhalation(p>0.05);CRC value showed a decrease compared with the control group without ischemic lesion(p<0.05).4.Compared the type of hyperactivity of liver Yang with the type of obstruction of phlegm-dampness in patients with cerebral ischemic lesions,there was no significant difference in CBF value between the two groups,and there was no significant difference in CRC value between the two groups(p>0.05).Conclusion 1.Arterial spin labeling combined with CO2 loading test can detect cerebral blood flow and cerebrovascular reserve function in control group and cerebral ischemic lesion group,and detect the reactivity of cerebrovascular.2.The cerebrovascular reserve function of patients with cerebral ischemic lesions was significantly decreased compared with the control group without ischemic lesions.3.There was no significant difference in cerebral blood flow and cerebrovascular reserve between the control group and the cerebral ischemic lesion group.4.There was no significant difference in cerebral blood flow and cerebrovascular reserve between the type of hyperactivity of liver Yang and the type of obstruction of phlegm-dampness in the cerebral ischemic lesion group.5.In the control group,the cerebral blood flow value of women was higher than that of men;in the cerebral ischemic lesion group,the cerebral blood flow value of bilateral superior frontal gyrus of women was higher than that of men,and there was no significant difference in the cerebral blood flow value of the remaining regions of interest.