磁共振ASL技术评估TIA患者急性脑梗死发病危险度的ROC曲线分析

ROC curve analysis of magnetic resonance ASL technique for assessing the risk of acute cerebral infarction in patients with TIA

目的探讨磁共振动脉自旋标记灌注图像(ASL)技术评估短暂性脑缺血发作(TIA)患者急性脑梗死(AIS)发病危险度的价值。方法选取2019年1月至2021年1月南京市江宁医院医学影像科收治的113例TIA患者,均行磁共振ASL技术检查,根据6个月内是否发生AIS分为AIS组(n=32)、无AIS组(n=81),比较两组基线资料、患侧CBF、健侧CBF、患侧/健侧CBF、狭窄程度,应用Pearson分析患侧CBF、患侧/健侧CBF、狭窄程度与ABCD^(2)评分关系,采用多因素Logistic回归方程分析的AIS相关影响因素,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析患侧CBF、患侧/健侧CBF、狭窄程度及联合预测AIS的价值。结果AIS组患侧CBF、患侧/健侧CBF低于无AIS组,狭窄程度、ABCD^(2)评分高于无AIS组(P<0.05);患侧CBF、患侧/健侧CBF与ABCD^(2)评分呈负相关,狭窄程度与ABCD^(2)评分呈正相关(P<0.05);将ABCD^(2)评分控制后,患侧CBF、患侧/健侧CBF、狭窄程度仍与AIS发生相关(P<0.05);患侧CBF、患侧/健侧CBF联合狭窄程度预测AIS的AUC最大。结论患侧CBF、患侧/健侧CBF、狭窄程度均与TIA患者发生AIS危险度有关,应用磁共振ASL技术检测脑组织血流灌注与颅内血管狭窄程度,能为临床预测AIS发生提供可靠参考。

Objective To explore the value of magnetic resonance arterial spin-labeled perfusion imaging(ASL) technology in assessing the risk of acute cerebral infarction(AIS) in patients with transient ischemic attack(TIA).Methods A total of 113 TIA patients admitted to the Medical Imaging Department of Nanjing Jiangning Hospital from January 2019 to January 2021 were selected for MRI ASL technical examination.According to whether AIS occurred within 6 months,they were divided into AIS group(n=32),No AIS group(n=81),the baseline data,affected side CBF,unhealthy CBF,affected/unhealthy CBF,and degree of stenosis were compared between the two groups.Pearson was used to analyze affected CBF,affected/unhealthy CBF,and degree of stenosis.ABCD^(2)score relationship,AIS related influencing factors analyzed by multivariate Logistic regression equation,receiver operating characteristic curve(ROC) and area under ROC(AUC) were used to analyze affected side CBF,affected side/unhealthy side CBF,degree of stenosis and combination predict the value of AIS.Results The affected side CBF and the affected/unhealthy CBF of the AIS group were lower than those of the no AIS group,and the degree of stenosis and ABCD^(2)score were higher than those of the no AIS group(P<0.05);the affected side CBF,the affected/unhealthy CBF and ABCD^(2)scores were negative correlation,the degree of stenosis was positively correlated with the ABCD^(2)score(P<0.05);after the ABCD^(2)score was controlled,the affected side CBF,the affected/unhealthy side CBF,and the degree of stenosis were still related to the occurrence of AIS(P<0.05);the affected side CBF,the affected side the combined stenosis degree of lateral/unhealthy CBF predicts the maximum AUC of AIS.Conclusion Ipsilateral CBF,affected/uninfected CBF,and degree of stenosis are all related to the risk of AIS in patients with TIA.The application of magnetic resonance ASL technology to detect brain tissue blood perfusion and the degree of intracranial vascular stenosis can provide reliable clinical prediction of the occurrence of AIS refer to.