摘要
目的探讨MR磁敏感加权成像(SWI)与动脉自旋标记成像(ASL)对急性期缺血性脑卒中患者预后评估及诊断价值。方法选取2018年6月~2019年6月经影像学检查及临床确诊急性期脑梗死患者64例,应用MRI分别选择行常规序列、ASL和SWI。将患者DWI异常高信号区周围高灌注(PLH)定义为PLH阳性。依据是否存在PLH,将64例患者分为PLH组(n=14)与对照组(n=50),分析SWI结合ASL对急性期缺血性脑卒中患者预后评估及诊断价值。结果PLH组与对照组入院当天用美国国立卫生研究院卒中量表(NIHSS)评分存在明显差别(P<0.05);54例轻型,8例中型,2例重型,PLH组14例入院当日NIHSS评分全部为轻型;PLH组14例,10例表现为预后好转,4例表现为稳定。64例患者中表现为进展状态的8例均为对照组患者;15例作为静脉异常组,17例急性梗死灶对侧与周围小静脉具有相似表现,作为静脉正常组;静脉异常分级与预后及梗死核心周围灌溉状态存在相关性(P<0.05)。结论对急性期缺血性脑卒中患者进行SWI结合ASL诊断,可对患者周围血流动力学情况准确提示,重复性强,不需要注射对比剂便可对患者病情评估,临床应用价值高。
Objective To evaluate the prognostic value and diagnostic value of MR magnetic susceptibility weighted imaging(SWI)and arterial spin labeling(ASL)in patients with acute ischemic stroke.Methods Sixty-six patients with acute cerebral infarction who underwent imaging examination and clinical diagnosis were selected from June 20 to June 2019.MRI was used to select routine,arterial spin-labeled imaging(ASL)and magnetic-sensitive weighted imaging(ASL).The presence of hyperperfusion around the abnormally high signal region of the patient's magnetic resonance diffusion-weighted imaging(DWI)was defined as PLH.According to the presence or absence of PLH,64 patients were divided into PLH group(n=14)and control group(n=50).The prognosis evaluation and diagnostic value of SWI combined with ASL in acute ischemic stroke patients were analyzed.Results There was a significant difference in the NIHSS score between the PLH group and the control group on admission(P<0.05).54 patients with light,8 patients with moderate,2 patients with severe disease,and 14 patients with PLH were admitted to the National Institutes of Health Stroke Scale.All NIHSS scores were mild;14 patients in the PLH group showed a prognosis improvement in 10 patients,and 4 patients showed stable and no progression.Eighty-four patients with progression status in 64 patients were all control patients.In this group of 64 patients,15 patients were treated as venous anomalies,and 17 patients with acute infarction had similar performance to the surrounding venules.There was a correlation between venous abnormal grading and prognosis and irrigation status around the infarct core(P<0.05).Conclusion SWI combined with ASL diagnosis in patients with acute ischemic stroke can accurately indicate the hemodynamics around the patient.It is highly reproducible and can be evaluated without the need for contrast agents.The clinical application value is high.
作者
王玮娜
王志伟
郑俊江
李静
姚海涛
WANG Weina;WANG Zhiwei;ZHENG Junjiang;LI Jing;YAO Haitao(Department of Radiology,Shijiazhuang Third Hospital,Shijiazhuang 050017,P.R.China;Department of Neurology,The People's Liberation Army No.260 Hospital,Shijiazhuang 050000,P.R.China;Taihang Community Health Service Center,Shijiazhuang High-tech Zone,Shijiazhuang 050000,P.R.China;Department of Ophthalmology,Xicheng Hospital of Integrated Traditional Chinese and Western Medicine,Shijiazhuang 052160,P.R.China;Department of Internal Medicine,Tangshan Jingdong Hospital,Tangshan 063500,P.R.China)
出处
《医学影像学杂志》
2020年第6期947-951,共5页
Journal of Medical Imaging
基金
河北省卫生和计划生育委员会医学科学研究重点课题计划项目(编号:20181047)。
关键词
急性期缺血性脑卒中
预后评估
诊断价值
磁共振成像
Acute ischemic stroke
Prognosis assessment
Diagnostic value
Magnetic resonance imaging
