Abstract：
OBJECTIVE: To evaluate the effect of stent implantation for vertebrobasilar artery stenosis，by using 3D arterial spin labeling (3D ASL) technique.
METHODS: A retrospective analysis was conducted on the clinical and 3D ASL data of 48 patients who underwent vertebral-basilar artery stenting. Post-labeling delay times (PLD) of 1.5 s and 2.5 s were chosen, and the average regional cerebral blood flow (rCBF) values were measured in nine brain regions of the posterior circulation: bilateral thalamus, bilateral occipital lobes, bilateral cerebellar hemispheres, midbrain, pons, and medulla. The 48 patients were divided into two groups based on the presence or absence of acute ischemic stroke in the posterior cerebral circulation region detected by diffusion-weighted imaging (DWI). The preoperative and postoperative rCBF results were statistically analyzed.
RESULTS: In the infarct group, there were significant increases in rCBF values of all nine brain regions at both PLD = 1.5 s and 2.5 s postoperatively compared to preoperatively. At PLD = 1.5 s, statistically significant differences in rCBF values between the preoperative and postoperative periods were found in the right thalamus, left cerebellum, midbrain, and pons regions (P < 0.05). At PLD = 2.5 s, statistically significant differences in rCBF values between the preoperative and postoperative periods were observed in the left occipital lobe, right cerebellum, midbrain, and pons regions (P < 0.05). When analyzing the rCBF values of the brain regions with recent infarcts in the infarct group, there was a significant increase in postoperative rCBF values compared to preoperative values (P < 0.05). After excluding the data from brain regions with recent infarcts, the CBF values in the remaining brain regions were also increased postoperatively, and some brain regions showed statistically significant differences in rCBF values between the preoperative and postoperative periods (P < 0.05). In the non-infarct group, there were no statistically significant differences in the preoperative and postoperative rCBF values in all brain regions at both PLD = 1.5 s and 2.5 s (P > 0.05).
CONCLUSIONS: The application of 3D ASL technology shows significant value in assessing the surgical efficacy of vertebral-basilar artery stenting, especially in patients with acute posterior circulation infarction.
METHODS: A retrospective analysis was conducted on the clinical and 3D ASL data of 48 patients who underwent vertebral-basilar artery stenting. Post-labeling delay times (PLD) of 1.5 s and 2.5 s were chosen, and the average regional cerebral blood flow (rCBF) values were measured in nine brain regions of the posterior circulation: bilateral thalamus, bilateral occipital lobes, bilateral cerebellar hemispheres, midbrain, pons, and medulla. The 48 patients were divided into two groups based on the presence or absence of acute ischemic stroke in the posterior cerebral circulation region detected by diffusion-weighted imaging (DWI). The preoperative and postoperative rCBF results were statistically analyzed.
RESULTS: In the infarct group, there were significant increases in rCBF values of all nine brain regions at both PLD = 1.5 s and 2.5 s postoperatively compared to preoperatively. At PLD = 1.5 s, statistically significant differences in rCBF values between the preoperative and postoperative periods were found in the right thalamus, left cerebellum, midbrain, and pons regions (P < 0.05). At PLD = 2.5 s, statistically significant differences in rCBF values between the preoperative and postoperative periods were observed in the left occipital lobe, right cerebellum, midbrain, and pons regions (P < 0.05). When analyzing the rCBF values of the brain regions with recent infarcts in the infarct group, there was a significant increase in postoperative rCBF values compared to preoperative values (P < 0.05). After excluding the data from brain regions with recent infarcts, the CBF values in the remaining brain regions were also increased postoperatively, and some brain regions showed statistically significant differences in rCBF values between the preoperative and postoperative periods (P < 0.05). In the non-infarct group, there were no statistically significant differences in the preoperative and postoperative rCBF values in all brain regions at both PLD = 1.5 s and 2.5 s (P > 0.05).
CONCLUSIONS: The application of 3D ASL technology shows significant value in assessing the surgical efficacy of vertebral-basilar artery stenting, especially in patients with acute posterior circulation infarction.
摘要：
目的：采用3D动脉自旋标记(3DASL)技术评价椎基底动脉狭窄支架植入术的疗效。
方法：对48例接受椎-基底动脉支架置入术患者的临床和3DASL资料进行回顾性分析。标记后延迟时间(PLD)选择为1.5s和2.5s，和平均局部脑血流量（rCBF）值在后循环的九个脑区测量：双侧丘脑，双侧枕叶，双侧小脑半球，中脑,pons,还有髓质.根据弥散加权成像（DWI）检测到的大脑后循环区域是否存在急性缺血性卒中，将48例患者分为两组。对术前、术后rCBF结果进行统计学分析。
结果：在梗死组，与术前相比,在PLD=1.5s和2.5s时,所有9个脑区的rCBF值均显著增加.在PLD=1.5s时，术前和术后期间的rCBF值在右丘脑中发现了统计学上的显着差异，左小脑,中脑,和脑桥区域(P<0.05)。在PLD=2.5s时，术前和术后期间的rCBF值在左枕叶观察到有统计学意义的差异，右小脑,中脑,和脑桥区域(P<0.05)。在分析梗死组有近期梗死的脑区的rCBF值时,与术前比较,术后rCBF值显著升高(P<0.05)。在排除了最近有梗塞的大脑区域的数据后，其余脑区的CBF值也在术后增加，部分脑区rCBF值在术前与术后比较差异有统计学意义(P<0.05)。在非梗死组,在PLD=1.5s和2.5s时，所有脑区的术前和术后rCBF值差异无统计学意义（P>0.05）。
结论：3DASL技术的应用在评估椎-基底动脉支架置入手术疗效方面具有重要价值。尤其是急性后循环梗死患者。
方法：对48例接受椎-基底动脉支架置入术患者的临床和3DASL资料进行回顾性分析。标记后延迟时间(PLD)选择为1.5s和2.5s，和平均局部脑血流量（rCBF）值在后循环的九个脑区测量：双侧丘脑，双侧枕叶，双侧小脑半球，中脑,pons,还有髓质.根据弥散加权成像（DWI）检测到的大脑后循环区域是否存在急性缺血性卒中，将48例患者分为两组。对术前、术后rCBF结果进行统计学分析。
结果：在梗死组，与术前相比,在PLD=1.5s和2.5s时,所有9个脑区的rCBF值均显著增加.在PLD=1.5s时，术前和术后期间的rCBF值在右丘脑中发现了统计学上的显着差异，左小脑,中脑,和脑桥区域(P<0.05)。在PLD=2.5s时，术前和术后期间的rCBF值在左枕叶观察到有统计学意义的差异，右小脑,中脑,和脑桥区域(P<0.05)。在分析梗死组有近期梗死的脑区的rCBF值时,与术前比较,术后rCBF值显著升高(P<0.05)。在排除了最近有梗塞的大脑区域的数据后，其余脑区的CBF值也在术后增加，部分脑区rCBF值在术前与术后比较差异有统计学意义(P<0.05)。在非梗死组,在PLD=1.5s和2.5s时，所有脑区的术前和术后rCBF值差异无统计学意义（P>0.05）。
结论：3DASL技术的应用在评估椎-基底动脉支架置入手术疗效方面具有重要价值。尤其是急性后循环梗死患者。
