多模态神经功能成像定量评估卒中溶栓治疗对脑血流动力学影响的实验研究

项目名称： 多模态神经功能成像定量评估卒中溶栓治疗对脑血流动力学影响的实验研究

项目编号： No.81201072

项目类型： 青年科学基金项目

立项/批准年度： 2013

项目学科： 影像医学与生物医学工程

项目作者： 程晓青

作者单位： 中国人民解放军南京军区南京总医院

项目金额： 23万元

中文摘要： 卒中可导致死亡及永久残废。溶栓疗法是当今治疗急性缺血性卒中最有前途的一种方法。卒中时间窗及神经功能缺损评分是筛选溶栓候选者、评估溶栓疗效及预测出血性转归的主要指标。然而，脑血流储备能力是卒中后脑组织的损伤程度及预后判断的主要因素，无法利用上述指标对其评估，MR/CT功能成像能够满足此要求。本项目拟建立血栓栓塞性卒中大鼠模型，对溶栓前后的大鼠进行MR/CT功能成像，溶栓前通过弥散与灌注加权成像的不匹配区预测缺血半暗带范围，利用CT灌注测量该区域CBF、CBV及TTP血流动力学参数。溶栓后通过血流动力学参数改变，明确挽救脑组织的范围，监测溶栓疗效，并进一步根据挽救脑组织溶栓前血流动力学参数明确缺血半暗带的阈值，为筛选溶栓候选者提供可靠指标。对溶栓后发生出血性转归的大鼠，将其血流动力学参数与溶栓前及预后良好大鼠对比，寻找有效的影像学预测指标。本研究结果为建立"影像学指导的溶栓模式"提供实验依据。

中文关键词： 卒中；磁共振；灌注；弥散成像；扩散峰度成像

英文摘要： Stroke is a major cause of morbidity and disability worldwide. Intravenous (IV) thrombolysis is the preferred treatment for patients with acute ischemic stroke who meet the National Institute of Neurological Disorders and Stroke trial Food and Drug Administration-approved criteria for tissue plasminogen activator(t-PA) administration. However, it remains problematic, for which patient's thrombolytic therapy is suitable and how to predict treatment outcomes. At present, the time window and the patient's National Institutes of Health Stroke Scale (NIHSS) score were used for selecting candidates for thrombolysis therapy and evaluating treatment outcomes. But, there was no quantitative parameter to evaluate the hemodynamic condition. In prophase study, we found that functional CT/MR multi- modal neuroimaging may help assessment hemodynamic parameters. Thus, we introduced the approach for studing of thrombolysis therapy. Accordingly, we used a rat model of thromboembolic stroke to evaluate the hemodynamic changes before and after thrombolysis therapy, especially for those rats that have hemorrhagic transformation (HT) after therapy. These aspects have received much attention in the stroke research especially for the development of treatment strategies .As will be demonstrated, this approach provides insight into the

英文关键词： stroke；MRI；perfusion；DWI；DKI