摘要
目的分析磁共振弥散加权成像(MRI-DWI)在脑梗死缺血半暗带评估及复发的预测价值。方法收集我院2020年1月~2022年6月收治的62例急性脑梗死患者临床资料,所有患者均在入院后行MRI检查,并接受静脉溶栓治疗,根据入院时DWI与液体衰减反转恢复序列(FLAIR)信号是否一致分为DWI-FLAIR匹配组与DWI-FLAIR不匹配组,比较两组基础疾病、梗死病灶区表观弥散系数(ADC)等基线资料及临床结局,并对所有患者随访1年,观察1年复发率。结果DWI-FLAIR不匹配组病灶体积及溶栓前美国国立卫生研究院卒中量表(NIHSS)评分均显著低于DWI-FLAIR匹配组(P<0.05),ADC值明显高于DWI-FLAIR匹配组(P<0.05)。DWI-FLAIR不匹配组溶栓1d及7d后NIHSS评分显著低于DWIFLAIR匹配组(P<0.05),溶栓30d后预后良好率高于DWI-FLAIR匹配组(P<0.05)。DWI-FLAIR不匹配组1年复发率明显低于DWI-FLAIR匹配组(3.57%vs 26.47%,P<0.05);1年复发患者初次入院时ADC值为(0.29±0.04)×10^(-3)mm^(2)/s,明显低于1年未复发患者入院时的ADC值(0.40±0.08)×10^(-3)mm^(2)/s(P<0.05),ROC曲线也显示,入院时ADC值对预测患者1年复发有统计学意义(P<0.05),其截断值为0.33×10^(-3)mm^(2)/s。结论DWI-FLAIR不匹配提示急性脑梗死患者存在缺血半暗带,静脉溶栓预后较好、复发风险较低,梗死病灶区ADC值也有利于预测患者1年复发风险。
Objective To analyze the value of magnetic resonance imaging-diffusion weighted imaging(MRI-DWI)on evaluating ischemic penumbra of cerebral infarction and predicting the recurrence.Methods Clinical data of 62 patients with acute cerebral infarction admitted to our hospital from January 2020 to June 2022 were collected.All patients underwent MRI examination after admission and received intravenous thrombolytic therapy.The patients were divided into DWI-FLAIR matching group and DWI-FLAIR nonmatching group according to the consistency of DWI and fluid-attenuated inversion-recovery sequence(FLAIR)signal at admission.Baseline data such as underlying disease and apparent diffusion coefficient(ADC)of infarction lesion and clinical outcomes were compared between the two groups.All patients were followed up for 1 year to observe the 1-year recurrence rate.Results The lesion volume and National Institutes of Health Stroke Scale(NIHSS)score before thrombolysis in DWI-FLAIR non-matching group were significantly less or lower than those in DWI-FLAIR matching group(P<0.05)while the ADC value was significantly higher than that in DWI-FLAIR matching group(P<0.05).NIHSS score in DWIFLAIR non-matching group was significantly lower than that in DWI-FLAIR matching group at 1 day and 7 days after thrombolysis(P<0.05)while the good prognosis rate after 30 days of thrombolysis was higher than that in DWI-FLAIR matching group(P<0.05).The 1-year recurrence rate was significantly lower in DWI-FLAIR non-matching group than that in DWI-FLAIR matching group(3.57%vs 26.47%,P<0.05).ADC value of patients with 1-year recurrence at initial admission was(0.29±0.04)×10^(-3)mm^(2)/s,which was significantly lower than(0.40±0.08)×10^(-3)mm^(2)/s of patients with 1-year non-recurrence at admission(P<0.05).ROC curve also showed that the ADC value at admission was statistically significant in predicting 1-year recurrence(P<0.05),and the cutoff value was 0.33×10^(-3)mm^(2)/s.Conclusion DWIFLAIR non-matching suggests ischemic penumbra,good prognosis o
作者
邢海昌
姜顺
刘淑玲
XING Hai-Chang;JIANG Shun;LIU Shu-ling(Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong Province,China)
出处
《中国CT和MRI杂志》
2024年第7期4-6,共3页
Chinese Journal of CT and MRI
关键词
脑梗死
缺血半暗带
磁共振
弥散加权成像
液体衰减反转恢复序列
静脉溶栓
复发
Cerebral Infarction
Ischemic Penumbra
Magnetic Resonance Imaging
Diffusion-weighted Imaging
Fluid-attenuated Inversion-Recovery Sequence
Intravenous Thrombolysis
Recurrence
