ASL评价急性期脑梗死患者侧支循环的临床应用价值

Clinical value of ASL in evaluating collateral circulation in patients with acute cerebral infarction

目的本研究应用ASL技术评估急性期脑梗死患者侧支循环状况,探讨ASL评价脑梗死患者侧支循环的临床应用价值。方法连续收集潍坊市中医院脑病四科的急性期脑梗死患者80例。依据DSA图像对脑梗死患者侧支循环开放程度进行评估分级,根据分级结果将患者分为侧支循环良好组和侧支循环不良组;依据ASL伪彩图梗死核心区周围是否出现条形高灌注信号,将患者分为侧支循环良好组和侧支循环不良组;比较分析两种方法判断侧支循环状态的一致性;通过灵敏度、特异度、假阴性率、假阳性率、一致率、阳性预测值、阴性预测值分析ASL对脑梗死侧支循环的评估价值,采用卡方检验分析两种方法诊断侧支循环级别的一致性。结果 ASL技术在评估急性期脑梗死患者侧支循环方面与DSA有较好的一致性,其灵敏度、特异度、假阴性率、假阳性率、一致率、阳性预测值、阴性预测值分别为94. 12%、86. 96%、5. 88%、13. 04%、90. 00%、84. 21%、95. 24%;两种方法诊断侧支循环级别无统计学差异。结论无创的ASL技术可应用于急性期脑梗死患者侧支循环的评价,其便捷、无辐射,可为患者的治疗及预后提供依据。

Objective ASL technology was used to evaluate the status of collateral circulation in patients with acute cerebral infarction,so as to evaluate the clinical value of ASL in collateral circulation.Methods The 80 patients with cerebral infarction were collected in our hospital.According to the DSA image,the subjects were divided into the good collateral circulation group and the bad group.Meanwhile,the patients were evaluated by ASL and divided into good collateral circulation group and the bad group according to whether there was strip hyperperfusion signal around the infarct core area.Two methods were analyzed to determine their consistency.The sensitivity,specificity,false negative rate,false positive rate,agreement rate,positive predictive value,negative predictive value were used to evaluate the value of ASL on the collateral circulation.Chi-square test was used to analyze the consistency of the two methods in diagnosing the level of collateral circulation.Results The ASL technique has a good consistency with DSA,and the above index values are were 94.12%,86.96%,5.88%,13.04%,90.00%,84.21%,95.24%respectively.There was no statistic significant difference between the two methods in diagnosis the level of collateral circulation.Conclusion Non-invasive ASL technology can be applied to evaluate the collateral circulation,and can provide evidence for the treatment and prognosis of patients with acute cerebral infarction.