磁共振液体反转恢复序列与弥散加权成像不匹配对进展性脑梗死的预测价值

The predictive value of FLAIR-DWI mismatch for progressive cerebral infarction

目的:探讨磁共振液体衰减反转恢复序列(FLAIR)与弥散加权成像(DWI)不匹配(FLAIR-DWI mismatch,FDM)对进展性脑梗死的预测作用。方法:选择2017年1月至2018年11月就诊的脑梗死患者40例,根据神经功能缺损有无加重分为进展组(9例)和非进展组(31例)。采集所有患者的临床和实验室相关数据,入院后均完成头颅FLAIR、DWI和MRA序列检查。分析FDM与进展性脑梗死的关系。结果:进展组低密度脂蛋白胆固醇[(3.41±0.51)mmol/L]高于非进展组[(2.70±0.67)mmol/L],差异有统计学意义(P=0.0058)。40例患者中,10例存在FDM,其中进展组7例(77.7%,7/9),非进展组3例(9.68%,3/31),两组差异有统计学意义(P<0.01)。logistic回归分析显示,FDM与进展性脑梗死的发生独立相关(P=0.0043)。结论:FDM可以作为进展性脑梗死的预测指标之一。

Objective:To investigate the predictive value of the fluid-attenuated inversion recovery(FLAIR)-diffusion-weighted imaging(DWI)mismatch(FDM)in MRI for progressive cerebral infarction(PCI).Methods:A total of 40 patients with PCI were selected from January 2017 to November 2018.According to the condition of the neurological deficit,40 patients were divided into the PCI group(n=9)and the non-progression group(n=31).The clinical and laboratory data of all patients were collected.All patients completed brain FLAIR,DWI,and magnetic resonance angiography(MRA).FDM was compared in progressive and non-progressive cerebral infarction.The relation between the FDM and the PCI was analyzed.Results:Low-density lipoprotein cholesterol(LDL-C)in the PCI group([3.41±0.51]mmol/L)was higher than that in the non-progression group([2.70±0.67]mmol/L),there was a statistical difference between the two groups(P=0.0058).FDM was observed in 10 patients,with 7 in the PCI group(77.7%,7/9)and 3 in the non-progression group(9.68%,3/31),there was a statistically significant difference between the two groups(P<0.01).Logistic regression analysis showed that FDM was independently associated with the occurrence of PCI(P=0.0043).Conclusions:The FDM could effectively predict the occurrence of PCI.