马鹏程;万文;王晋;邬刚;彭桂兰;李青芸;董小林;马立柔;

• 1:昆明市延安医院

摘要(Abstract)：

目的探讨磁共振三维准连续动脉自旋标记(3D-PCASL)扫描技术在偏头痛患者发作期中的应用价值。方法收集2019-01—05在昆明市延安医院就诊的20例偏头痛患者及20例健康志愿者,采用磁共振三维准连续动脉自旋标记扫描技术进行脑灌注扫描,病例组分别在发作期和间歇期扫描,健康组在平息状态下扫描,测量2组脑血流量(CBF)并进行比较。结果实验组疼痛发作期患侧颞叶CBF值[(53.14±3) mL/(100 g·min)]低于健侧[(54.99±3.18) mL/(100 g·min),t=-2.125,P<0.05],病患组颞叶CBF灌注值[(53.14±3) mL/(100 g·min)]较对应健康对照组区域[(55.99±2.44)mL/(100 g·min),t=-3.308,P<0.05]减低。病例组在间歇期CBF值未见明显变化。结论三维准连续动脉自旋标记扫描技术能够监测健侧全脑血流灌注情况,对偏头痛患者进行量化分析,为临床医生提供客观的诊疗依据。

关键词(KeyWords)： 动脉自旋标记;偏头痛;磁共振成像;脑血流量;全脑灌注

Abstract:

Keywords:

基金项目(Foundation): 云南省教育厅科学研究基金项目(编号:2018JS237);; 昆明市卫生科技人才培养项目暨“十百千”工程项目[编号:2018-sw(后备)-12];昆明市卫生科技人才培养项目暨“内设研究机构”建设项目[编号:2018-sw(后备)-60];; 昆明市延安医院院内项目(编号:yyky019-021)

作者(Authors): 马鹏程;万文;王晋;邬刚;彭桂兰;李青芸;董小林;马立柔;

参考文献(References)：

• [1] SHAH D R,DILWALI S,FRIEDMAN D I.Migraine Aura Without Headache[J].Curr Pain Headache Rep,2018,22(11):77.DOI:10.1007/s11916-018-0725-1.
• [2] COLOMBO B,TEGGI R,NIVE Project.Vestibular migraine:who is the patient?[J].Neurol Sci,2017,38(Suppl 1):107-110.DOI:10.1007/s10072-017-2882-0.
• [3] TINSLEY A,ROTHROCK J F.What Are We Missing in the Diagnostic Criteria for Migraine?[J].Curr Pain Headache Rep,2018,22(12):84.DOI:10.1007/s11916-018-0733-1.
• [4] Global Burden of Disease Study 2013 Collaborators.Global,regional,and national incidence,prevalence,and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries,1990-2013:a systematic analysis for the Global Burden of Disease Study 2013[J].Lancet,2015,386(9995):743-800.DOI:10.1016/S0140-6736(15)60692-4.
• [5] Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders,3rd edition[J].Cephalalgia,2018,38(1):1-211.DOI:10.1177/0333102417738202.
• [6] HALLER S,ZAHARCHUK G,THOMAS D L,et al.Golay,Arterial Spin Labeling Perfusion of the Brain:Emerging Clinical Applications[J].Radiology,2016,281(2):337-356.DOI:10.3874/j.issn.1674-1897.2015.01.Z0111.
• [7] SAKASHITA Y,HAMADA T,MACHIYA T,et al.Acute intermittent porphyria presenting as posterior reversible encephalopathy syndrome with hyperperfusion in bilateral occipital lobes:A case report[J].J Neurol Sci,2017,377:47-49.DOI:10.1016/j.jns.2017.03.052.
• [8] YAMAMOTO N,SATOMI J,YAMAMOTO Y,et al,Usefulness of 3-Tesla magnetic resonance arterial spin-labeled imaging for diagnosis of cranial dural arteriovenous fistula[J].J Neurol Sci,2017,372:428-432.DOI:10.1016/j.jns.2016.11.011.
• [9] MATSUURA K,MAEDA M,OKAMOTO K,et al.Usefulness of arterial spin-labeling images in periictal state diagnosis of epilepsy[J].J Neurol Sci,2015,359(1/2):424-442.DOI:10.1016/j.jns.2015.10.009
• [10] GIANI L,LOVATI C,CORNO S,et al.Cerebral blood flow in migraine without aura:ASL-MRI case control study[J].Neurol Sci,2019,40(Suppl 1):183-184.DOI:10.1007/s10072-019-03806-6.
• [11] CORNO S,GIANI L,LAGANà M M,et al.The brain effect of the migraine attack:an ASL MRI study of the cerebral perfusion during a migraine attack[J].Neurol Sci,2018,39(Suppl 1):73-74.DOI:10.1007/s10072-018-3346-x.
• [12] FERRARI M D,KLEVER R R,TERWINDT G M,et al.Migraine pathophysiology:lessons from mouse models and human genetics[J].Lancet Neurol,2015,14(1):65-80.DOI:10.1016/S1474-4422(14)70220-0.
• [13] 迟蕊,张美艳,潘心,等.偏头痛与脑白质病变相关性的研究进展[J].中国实用神经疾病杂志,2020,23(8):734-736;封3.DOI:10.12083/SYSJ.2020.08.172.
• [14] ROSCISZEWSKA-ZUKOWSKA I,ZAJAC-MNICH M,JANIK P.Characteristics and clinical correlates of white matter changes in brain magnetic resonance of migraine females[J].Neurol Neurochir Pol,2018,52(6):695-703.DOI:10.1016/j.pjnns.2018.09.007.
• [15] 段智慧,杨致远,宋彬彬,等.c-TCD联合c-TTE在卵圆孔未闭右向左分流诊断中的应用[J].中国实用神经疾病杂志,2019,22(2):183-186.DOI:10.12083/SYSJ.2019.02.035.
• [16] MEYER M M,SCHMIDT A,BENRATH J,et al.Cerebral sodium (23Na) magnetic resonance imaging in patients with migraine - a case-control study[J].Eur Radiol,2019,29(12):7055-7062.DOI:10.1007/s00330-019-06299-1.
• [17] BJ?RNSSON A,GUDMUNDSSON G,GUDFINNSSON E,et al.Localization of a gene for migraine without aura to chromosome 4q21[J].Am J Hum Genet,2003,73(5):986-993.DOI:10.1086/378417.
• [18] SORAGNA D,VETTORI A,CARRARO G,et al.A locus for migraine without aura maps on chromosome 14q21.2-q22.3[J].Am J Hum Genet,2003,72(1):161-167.DOI:10.1086/345298.
• [19] CHONG C D,GAW N,FU Y,et al.Migraine classification using magnetic resonance imaging resting-state functional connectivity data[J].Cephalalgia,2017,37(9):828-844.DOI:10.1177/0333102416652091.
• [20] DE BENEDITTIS G,FERRARI DA PASSANO C,GRANATA G,et al.CBF changes during headache-free periods and spontaneous/induced attacks in migraine with and without aura:a TCD and SPECT comparison study[J].J Neurosurg Sci,1999,43(2):141-146;discussion 146-147.
• [21] WOLF M E,OKAZAKI S,EISELE P,et al.Arterial Spin Labeling Cerebral Perfusion Magnetic Resonance Imaging in Migraine Aura:An Observational Study[J].J Stroke Cerebrovasc Dis,2018,27(5):1262-1266.DOI:10.1016/j.jstrokecerebrovasdis.2017.12.002.
• [22] LAW-YE B,FARGEOT G,LECLERCQ D.Arterial Spin Labeling Hypoperfusion in Migraine Aura[J].Headache,2017,57(6):935-936.DOI:10.1111/head.13072.
• [23] BURNS R,DE MALHERBE M,CHADENAT M L,et al.Arterial Spin-Labeled MR Imaging Detecting Biphasic Neurovascular Changes in Migraine With Persistent Aura[J].Headache,2017,57(10):1627-1628.DOI:10.1111/head.13119.
• [24] HODKINSON D J,VEGGEBERG R,WILCOX S L,et al.Primary Somatosensory Cortices Contain Altered Patterns of Regional Cerebral Blood Flow in the Interictal Phase of Migraine[J].PLoS One,2015,10(9):e0137971.DOI:10.1371/journal.pone.0137971.
• [25] MULLALLY W J,HALL K E.Value of Patient-Directed Brain Magnetic Resonance Imaging Scan with a Diagnosis of Migraine[J].Am J Med,2018,131(4):438-441.DOI:10.1016/j.amjmed.2017.10.042.
• [26] COLOMBO B,MESSINA R,ROCCA M A,et al.Imaging the migrainous brain:the present and the future[J].Neurol Sci,2019,40(Suppl 1):49-54.DOI:10.1007/s10072-019-03851-1.
• [27] SULEJMANPA?IC G,FI?EKOVIC S,DRNDA S.Morphologic differences of occipital region in patients with schizophrenia and migraine headache using magnetic resonance imaging (MRI) and visual evoked potentials (VEPs)[J].Med Glas (Zenica),2017,14(1):117-125.DOI:10.17392/884-16.
• [28] SCHWEDT T J,CHONG C D,WU T,et al.Accurate Classification of Chronic Migraine via Brain Magnetic Resonance Imaging[J].Headache,2015,55(6):762-777.DOI:10.1111/head.12584.