The Application Value Of 3D-ASL Combined With CE-MRA In TIA

Section 1: Measurement and evaluation of brain blood flow for healthy personObjective: To find out the best diagnosis method for brain diseases,statistical analysis were applied to detect the difference among the measurements of the Cerebral Brain Flow(CBF)for brain white matter,gray matter by 3D-pulsed continuous Arterial Spin Labeling(ASL)in different ages and genders.Methods: 64 healthy volunteers were divided into four groups named juvenile(group A,7-17 years old),youth(group B,18-40 years old),the middle-aged(group C,41-65 years old),and the elderly(group D,>65 years old).Each group had 16 volunteers including 8 males and 8 females.Volunteers were Imaged by Routine Magnetic Resonance and checked by 3D-p CASL sequences,tagging the Post-Labeling Delay(PLD)as 1.5 seconds.The obtained images were first be pre-treated by special work station and selected symmetry ROI to measure the CBF value for bilateral cerebral hemisphere leaf and cortex,then the difference of CBF value between the left and right brain hemispheres its relationship with age and sex were compared and analyzed respectively.Results:(1)No significant difference was found for frontal temporal occipital white matter,cortex,and CBF of cerebellar hemispheres for double size.(2)CBF of brain parenchyma for female was higher than male.Meanwhile,female's mean CBF of occipital white matter(29.7±1.94 m L/(min 100 g))was also obviously higher(P<0.05)than male(28.66±1.75 m L/(min 100 g)).(3)Blood flow of temporal cortex decreased with age.(4)CBF of frontal white matter,parietal white matter,and cortex of forehead,temporal,and occipital were 28.34±2.12?26.41±2.7?61.47±1.76?51.34±2.47?59.19±2.68?51.25±3.75 m L/(min 100 g)in group D,which are significantly lower than other three groups(P<0.05).Conclusion:(1)The CBF of healthy people is almost symmetric on both sides.(2)The CBF of healthy people also vary from age and gender.Section 2: Clinical Value of 3D-ASL and CE-MRA Combination for TIA DiagnosisObjective: Combine 3D-ASL with contrast-enhanced magnetic resonance angiography(CEMRA)sequence for the diagnosis of transient isc hemic attack(TIA)diseases.Methods: We firstly Selected 58 patients who were highly doubted or diagnosed Transient Ischemic Attack(TIA)in clinical and divided them into internal carotid artery group(group A)and vertebrobasilar artery group(group B).Then,Time-Of-Flight Magnetic Resonance Angiography(TOF MRA)sequence,3D-ASL and CE MRA inspections were performed for all 58 patients.blood vessels were divided into internal carotidartery(type A),middle cerebral artery(type B),vertebrobasilar artery(type C),and posterior cerebral artery(type D)of both sides respectively.The conditions of blood vessels(e.g.stenosis)for the two groups(A&B)were analyzed and CBF for Frontal temporal occipital lobe and cerebellar hemisphere of both sides were measured and abnormal perfusion was marked when CBF was smaller than 20 m L/(min 100 g).The relationship between abnormal perfusion and blood vessels was also detected in our study.All patients underwent magnetic resonance after treatment,and patients with abnormal perfusion were randomly selected to review the ASL sequence.Results: No significantabnormity was detected in magnetic resonance scan for all 58 TIA patients.(1)There were 34 of the 48 patients with abnormal perfusion indicated arterial artery stenosis and branches scarce and only 3 of the 10 normal perfusion patients showed slightly branches scarce of blood vessels.(2)there were 13 of the 22 patients in group A had internal carotid artery and posterior cerebral artery stenosis of both sides.Meanwhile,15 of the 22 patients in group A indicated frontal lobe abnormal perfusion.33 patients in group B were found low perfusion for occipital and cerebellar hemispheres of both sides and 24 patients in group B had bilateral vertebrobasilar artery and bilateral posterior cerebral artery stenosis.(3)64% hemadostenosis was found for TIA patients by CE-MRA while 83% abnormal perfusion of TIA patients could be detected by 3D-ASL.(4)All TIA patients did not develop into stroke after treatment,and 10 patients were randomly selected and found the infusion area was consistent with that before treatment.Conclusion:(1)CE-MRA can accurately assess head and neck blood vessels,distal small branch shows better than 3D-TOF-MRA.(2)3D-ASL technology can find ischemic brain tissue area early for most TIA patients,using 3D-ASL together with CE-MRA couldalso contribute to detect the relevant vessels...