DWI联合FLAIR-HVS对ACI缺血半暗带存活性及神经功能缺损程度的研究

doi:10.7517/issn.1674-0475.220821

摘要/Abstract

摘要： 本文探讨弥散加权成像(DWI)联合液体衰减反转恢复(FLAIR)高信号血管征(HVS)在急性脑梗死(ACI)患者缺血半暗带存活性及神经功能缺损程度评估中的价值。选取120例ACI患者,给予DWI和FLAIR序列扫描,分析梗死区、脑缺血半暗带和可存活区表观弥散系数(ADC)值、相对表观弥散系数(rADC)值。发现脑缺血半暗带和可存活区ADC值明显高于梗死区(P＜0.05),可存活区rADC值明显高于脑缺血半暗带和梗死区(P＜0.05)。rADC值预测可存活区的ROC曲线下面积为0.715,P＜0.05。HVS-DWI不匹配患者随访3个月预后良好率明显高于无HVS-DWI不匹配患者(P＜0.05)。随神经功能缺损程度、梗死体积、血管狭窄程度增加,HVS-DWI不匹配比例明显降低(P＜0.05)。DWI在ACI缺血半暗带存活性预测方面有一定应用价值,HVS-DWI不匹配与神经功能缺损程度、梗死体积、血管狭窄程度及预后有一定关系。

关键词: 弥散加权成像, 液体衰减反转恢复, 高信号血管征, 急性脑梗死, 缺血半暗带存活性, 神经功能缺损程度

Abstract: This paper discussed the value of diffusion weighted imaging (DWI) combined with fluid-attenuated inversion recovery (FLAIR) hyperintense vessel sign (HVS) in evaluating the viability of ischemic penumbra and the degree of neurological deficit in patients with acute cerebral infarction (ACI). 120 patients with ACI were scanned with DWI and FLAIR sequences, apparent dispersion coefficient (ADC) value, relative apparent dispersion coefficient (rADC) value of infarcted area, ischemic penumbra and survivable area were analyzed. ADC values in ischemic penumbra and viable areas were significantly higher than those in infarcted areas (P<0.05), and rADC values in viable areas were significantly higher than those in ischemic penumbra and infarcted areas (P<0.05). The area under ROC curve of viable areas predicted by rADC value was 0.715, P<0.05. The good prognosis rate of patients with HVS-DWI mismatch was significantly higher than that of patients without HVS-DWI mismatch (P<0.05) at 3 months of follow-up. The mismatch ratio of HVS-DWI decreased significantly with the increase of neurological deficit, infarct volume and vascular stenosis (P<0.05). DWI has certain application value in predicting the viability of ischemic penumbra in ACI. HVS-DWI mismatch is related to the degree of neurological deficit, infarct volume, degree of vascular stenosis and prognosis.

Key words: diffusion weighted imaging, fluid-attenuated inversion recovery, hyperintense vessel sign, acute cerebral infarction, ischemic penumbra viability, degree of neurological deficit

方雷, 孙慧芹, 李洪凤. DWI联合FLAIR-HVS对ACI缺血半暗带存活性及神经功能缺损程度的研究[J]. 影像科学与光化学, 2022, 40(6): 1607-1611.

FANG Lei, SUN Huiqin, LI Hongfeng. Study of DWI Combined with FLAIR-HVS on Ischemic Penumbra Viability and the Degree of Neurological Deficit in ACI[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(6): 1607-1611.

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