缺血性脑血管病患者MRI FLAIR序列远端HVS与预后的关系

Correlation Between Distal HVS of MRI FLAIR Sequence with Prognoses in Patients with Ischemic Cerebrovascular Disease

目的探究缺血性脑血管病(ICVD)患者磁共振液体衰减反转恢复(MRI FLAIR)序列远端高信号血管征(HVS)与预后的相关性。方法回顾性分析2018年11月—2020年6月128例ICVD的临床资料,根据是否存在MRI FLAIR序列远端HVS分为HVS阳性组(存在远端HVS)61例及HVS阴性组(存在近端HVS或无HVS)67例,比较两组基线资料及出院时美国国立卫生研究院卒中量表(NIHSS)、改良Rankin评分(mRS)差异。根据远端HVS分级将HVS阳性组分为Ⅱ级组35例、Ⅲ级组26例,比较两组出院时NIHSS、mRS评分差异,并分析远端HVS分级与ICVD患者预后指标的相关性。结果HVS阳性组梗死体积和入院NIHSS评分低于HVS阴性组,出院时NIHSS及mRS评分也低于HVS阴性组(P<0.01)。Ⅱ级组出院时NIHSS及mRS评分均高于Ⅲ级组(P<0.01)。经Spearman秩相关分析,远端HVS分级与ICVD患者出院时NIHSS及mRS评分呈显著负相关(P<0.01)。结论MRI FLAIR序列远端HVS能辅助判断ICVD患者病情,对近期预后的评估也有一定应用价值。

Objective To explore the correlation between distal hyperintense vessel signs(HVS)of magnetic resonance imaging fluid attenuated inversion recovery(MRI FLAIR)sequence with prognoses in patients with ischemic cerebrovascular disease(ICVD).Methods Clinical data of 128 patients with ICVD between November 2018 and June 2020 was retrospectively analyzed.The patients were divided into positive HVS group(presence of distal HVS,n=61)and negative HVS group(presence of proximal HVS or absence of HVS,n=67)according to the presence or absence of distal HVS of MRI FLAIR sequence.The baseline data and scores of National Institutes of Health Stroke Scale(NIHSS)and Modified Rankin Score(mRS)at discharge were compared between two groups.According to the distal HVS grading,patients with distal positive HVS were divided into gradeⅡsubgroup(n=35)and gradeⅢsubgroup(n=26),and differences in scores of NIHSS and mRS at discharge were compared between the two subgroups,and then the correlations between distal HVS grading with prognostic indicators of patients with ICVD were analyzed.Results Compared with those in negative HVS group,infarct area and NIHSS score at admission were significantly lower,and scores of NIHSS and mRS at discharge were also significantly lower in positive HVS group(P<0.01).Scores of NIHSS and mRS at discharge in gradeⅡsubgroup were significantly higher than those in gradeⅢsubgroup(P<0.01).Spearman rank correlation analysis showed that distal HVS grading was negatively correlated with scores of NIHSS and mRS at discharge significantly in patients with ICVD(P<0.01).Conclusion Distal HVS of MRI FLAIR sequence may assist in judging the disease condition with a certain application value in evaluating the short-term prognoses of patients with ICVD.