MRI联合DWI成像评估早期脑梗死缺血半暗带患者价值分析

Evaluation of the Value of MRI Combined with DWI Imaging in Patients with Ischemic Penumbra in Early Cerebral Infarction

目的 探讨磁共振成像(MRI)联合弥散加权成像(DWI)成像评估早期脑梗死缺血半暗带患者临床价值。方法 本研究选择我院于2021年1月~2022年12月早期脑梗死患者100例,分为超急性期组44例(发病<6h)与急性期组56例(发病6~12h)。所有患者均行MRI联合DWI检查。并取得不同时间缺血半暗带区各参数相对值,即rDCavg、rADC和rFA。比较早期脑梗死患者患侧与健侧的定量参数;比较超急性期组与急性期组缺血半暗带区的定量参数;采用ROC曲线分析定量参数对缺血半暗带预测价值。结果 梗死核心区和缺血半暗带区DCavg、ADC和FA低于健侧区(P<0.05);且梗死核心区DCavg、ADC和FA低于缺血半暗带区(P<0.05)。超急性期组rDCavg、rADC和rFA高于急性期组(P<0.05)。经ROC曲线分析显示,缺血半暗带预测价值中,DCavg灵敏度为81.0%,特异度为87.0%;ADC灵敏度为65.0%,特异度为63.0%;FA灵敏度为65.0%,特异度为63.0%;联合预测灵敏度为88.5%,特异度为96.0%。联合预测灵敏度和特异度高于DAavg、ADC和FA单项指标(P<0.05)。结论 MRI联合DWI成像评估早期脑梗死缺血半暗带患者价值良好,可提高预测灵敏度和特异度。

Objective Explore the clinical value of MRI combined DWI in evaluating ischemic penumbra patients with early CI.Methods In this study,100 patients with early cerebral infarction in our hospital from January 2021 to December 2022 were selected as the study subjects.According to the onset time,they were divided into a hyperacute phase group of 44 patients(onset<6 hours) and an acute phase group of 56 patients(onset 6-12 hours).All patients underwent MRI combined with DWI,to measure relevant parameter data map obtained by MRI combined with DWI was automatically generated.The relative values of various parameters in the ischemic penumbra at different times were obtained,namely,rDCavg,rADC,and rFA.Compare the quantitative parameters of the affected side and the healthy side in patients with early cerebral infarction;compare the quantitative parameters of ischemic penumbra between the hyperacute phase group and the acute phase group;the predictive value of quantitative parameters for ischemic penumbra was analyzed using ROC curves.Results The levels of DCavg,ADC,and FA in the infarcted core and ischemic penumbra lower than contralateral area(P<0.05);the levels of DCavg,ADC,and FA in the infarcted core lower than ischemic penumbra(P<0.05).RDCavg,rADC,and rFA in the hyperacute group were higher than those in the acute group(P<0.05).The ROC curve analysis showed that among the predictive values of ischemic penumbra,the sensitivity and specificity of DCavg were 81.0% and 87.0%,respectively;ADC has a sensitivity of 65.0%and a specificity of 63.0%;the sensitivity and specificity of FA were 65.0% and 63.0%,respectively;the sensitivity and specificity of combined prediction were 88.5% and 96.0%,respectively.The sensitivity and specificity of combined prediction were higher than those of DAavg,ADC,and FA(P<0.05).Conclusion MRI combined with DWI imaging has good value in evaluating patients with ischemic penumbra in early cerebral infarction,and can improve the predictive sensitivity and specificity.