급성 및 아급성 뇌경색 환자에서 관류 자기공명영상의 임상적 유용성：중소병원의 경험

Abstract

Background：To present a community-hospital-based experiences of multimodal MR imaging for the evaluation of patients with acute or subacute cerebral ischemia with an emphasis on the usefulness of perfusion MR. Materials and Methods：As a control, perfusion MR imaging was performed in two healthy adult volunteers. Diffusion-weighted imaging (DWI), MR angiography (MRA) and perfusion MR imaging were performed in 23 (13 acute and 10 subacute)patients. Four kinds of perfusion parameter maps were obtained. DWI and relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) maps were analyzed in terms of the size and location of lesions. MRA and mean transit time (MTT) and time to peak concentration (TTP) maps were analyzed in terms of the signal intensity and perfusion defect pattern of lesions. The patients were divided into three groups according to the grades of muscle strength and the size of lesion on DWI. The perfusion defect pattern of the lesions in each group were observed. Results：The size and location of lesions on DWI were comparable to those on rCBV and rCBF in 15 (65%) of 23 patients. In 13 cases, stenoocclusive lesions were noted on MRA and 12 (92%) of them showed fan-shaped large perfusion defect in the corresponding vascular territories. The DWI and perfusion MR findings of each patient group divided by muscle strength were presented. Conclusion：According to out limited experiences, multimodal MR imaging which includes DWI, perfusion MR imaging and MRA was helpful in the diagnosis and estimation of prognosis in patients with acute or subacute cerebral infarction in a community-based hospital. (Korean Journal of Stroke 2006;8:191-196)