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目的探讨磁共振灌注成像评价急性期单侧幕上大脑中动脉区脑梗死后对侧小脑半球灌注量改变的诊断价值。资料与方法搜集38例幕上急性期脑梗死患者进行双侧小脑半球磁共振灌注成像(perfusion-weightedimaging,PWI),通过测量双侧小脑半球相对脑血容量(relative cerebral blood volume,rCBV)、相对脑血流量(relativecerebral blood flow,rCBF)和平均通过时间(relative mean transit time,rMTT)及达峰时间(relative time to peak,rTTP),判断幕上梗死病灶对侧小脑半球的灌注情况。结果 38例中,16例患者对侧小脑半球的rTTP延长,较健侧延长约(133.28±70.25)%;rMTT值较健侧延长约(82.78±91.22)%,但无统计学意义(P=0.112,P>0.05);rCBF较健侧降低约(53.74±41.56)%;rCBV较健侧降低约(100.58±91.72)%。结论部分幕上脑梗死患者可造成病变对侧小脑半球低灌注,并与梗死原发灶的体积相关,提示这些患者可能存在交叉性小脑机能联系不能(crossedcerebellar diaschisis,CCD)。
Objective To evaluate the diagnostic value of MR perfusion imaging in assessing changes of perfusion of lateral cerebellar hemisphere after acute cerebral infarction in unilateral supratentorial middle cerebral artery. Materials and Methods 38 cases of supratentorial acute cerebral infarction were collected for perfusion-weightedimaging (PWI). By measuring the relative cerebral blood volume (rCBV) of bilateral cerebellar hemispheres, Cerebral blood flow (rCBF), relative mean transit time (rMTT) and relative time to peak (rTTP) were used to evaluate the perfusion of suprasellar hemisphere in supratentorial infarct. Results Among the 38 cases, rTT prolonged about 16.6% (133.28 ± 70.25)% in the lateral cerebellar hemisphere and 82.78 ± 91.22% in the right side of the contralateral hemisphere, but there was no statistical significance (P = 0.112, P> 0.05). The rCBF was decreased by about 53.74 ± 41.56% compared with that of the uninjured side, and the reduction of rCBV was (100.58 ± 91.72)%. Conclusions Some patients with supratentorial cerebral infarction may cause hypoperfusion in the contralateral cerebellar hemisphere and correlate with the volume of the primary infarct, suggesting crossed cerebellar disaschisis (CCD) in these patients.