MR FLAIR诊断缺血性脑卒中的应用研究

Application of MR FLAIR in the diagnosis of ischemic stroke

目的探究MR液体衰减反转恢复(fluid-attenuated inversion recovery,FLAIR)序列在缺血性脑卒中诊断中的应用价值。材料与方法回顾性分析本院2019年1月至2020年3月连续收集的150例缺血性脑卒中患者的临床及MR影像学资料,根据FLAIR序列高信号血管征(hyperintense vessel sign,HVS)信号强弱将患者分为A组(HVS<5分,53例)和B组(HVS≥5分,97例),比较两组患者的临床及影像学特征,分析不同HVS评分与神经功能缺损程度、脑侧支循环代偿分级、基于扩散加权成像(diffusion-weighted imaging,DWI)的Alberta卒中项目早期CT评分(DWI-ASPECTS)和脑梗死体积之间的关系。结果两组患者的性别、年龄、发病至MRI检查时间、高血压、糖尿病、高脂血症、吸烟史和饮酒史等方面比较,差异无统计学意义(P>0.05);A组患者的心房颤动占比(39.62%与20.62%)和美国国立卫生研究院卒中量表(NIHSS)评分[(14.65±2.54)与(12.87±3.27)]均高于B组(P<0.05);A组患者的脑侧支循环代偿分级为(1.86±0.45)级,DWI-ASPECTS评分为(7.76±1.23)分,小于B组的(2.27±0.64)级和(8.25±1.34)分(P<0.05);A组患者的脑梗死体积为(54.28±12.34)cm^(3),大于B组的(25.67±8.63)cm^(3),差异有统计学意义(P<0.05)。结论MR FLAIR在诊断缺血性脑卒中方面具有良好价值,患者的HVS评分越高预示脑侧支循环代偿越好,神经功能缺损程度越低,脑梗死体积越小,对缺血性脑卒中的临床治疗具有重要指导意义。

Objective:To explore the application value of MR fluid-attenuated inversion recovery(FLAIR)sequence in the diagnosis of ischemic stroke.Materials and Methods:The clinical and MR imaging data of 150 patients with ischemic stroke treated in the hospital between January 2019 and March 2020 were retrospectively analyzed.According to the strength of FLAIR sequence hyperintense vessel sign(HVS),the patients were divided into group A(HVS<5 points,n=53)and group B(HVS≥5 points,n=97).Clinical and imaging characteristics of the two groups were compared.The relationship between different HVS scores and the severity of neurological deficit and cerebral collateral circulation compensation grading,the relationship between Alberta Stroke Program Early CT Score(ASPECTS)on diffusion weighted imaging(DWI-ASPECTS)and cerebral infarction volume were analyzed.Results:There were no significant differences in gender,age,time from onset to MR examination,hypertension,diabetes,hyperlipidemia,smoking history and drinking history between the two groups(P>0.05).The proportion of atrial fibrillation and National Institute of Health Stroke Scale(NIHSS)score of group A were higher than those of group B[39.62%vs.20.62%,(14.65±2.54)points vs.(12.87±3.27)points](P<0.05).The grade of cerebral collateral circulation compensation and DWI-ASPECTS score were lower than group B[(1.86±0.45)vs.(2.27±0.64),(7.76±1.23)points vs.(8.25±1.34)points](P<0.05).The cerebral infarction volume of group A was larger than that of group B[(54.28±12.34)cm^(3) vs.(25.67±8.63)cm^(3)](P<0.05).Conclusions:MR FLAIR is of value in the diagnosis of ischemic stroke.The higher the HVS score,the better the cerebral collateral circulation compensation,the milder the neurological deficit,and the smaller the cerebral infarction volume,which is of great significance for ischemic stroke.