DCE-MRI定量参数与急性脑梗死患者神经功能及预后的关系

Relationship between DCE-MRI Quantitative Parameters and Neural Function,Prognosis in Patients with Acute Cerebral Infarction

目的:分析磁共振动态增强成像(DCE-MRI)定量参数与急性脑梗死(ACI)患者神经功能及预后的关系。方法:选取2019年10月-2021年10月某院诊治的80例急性脑梗死患者进行研究。所有患者均进行DCE-MRI检查,通过后处理软件计算定量参数,同时采用常用工具量表准确评估ACI患者的神经功能和预后,分析DCE-MRI定量参数与ACI患者神经功能缺损程度和预后的相关性,以及DCE-MRI定量参数对ACI患者神经功能缺损程度和预后的预测价值。结果:轻度缺损组的容积转运常数(K^(trans))、血管外细胞外容积分数(V_(e))、速率常数(K_(ep))、血浆容积分数(V_(p))均小于中重度缺损组(P<0.05);预后良好组的K^(trans)、V_(e)、K_(ep)、V_(p)均小于预后不良组(P<0.05);经Spearman相关分析,K^(trans)、V_(e)、K_(ep)、V_(p)与美国国立卫生研究院卒中量表(NIHSS)评分和Modified Rankin量表(MRS)评分呈正相关;K^(trans)、V_(e)、K_(ep)、V_(p)预测ACI患者神经功能缺损程度的曲线下面积(AUC)分别为0.693、0.724、0.660、0.717,预测ACI患者预后的AUC分别为0.775、0.786、0.776、0.732。结论:DCE-MRI定量参数水平可反映ACI患者的神经功能和预后,且具有显著相关性。

Objective:To analyze the relationship between the quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and neural function,prognosis in patients with acute cerebral infarction(ACI).Methods:A total of 80 patients with ACI treated in a hospital from October 2019 to October 2021 were selected.All patients underwent DCE-MRI.The quantitative parameters were calculated by post-processing software.The neural function and prognosis of ACI patients were accurately assessed by commonly used scales.The correlation between quantitative parameters of DCE-MRI and neurological deficits,prognosis,and their predictive value for the two indexes in ACI patients were analyzed.Results:The volume transfer constant(K^(trans)),extravascular extracellular space fraction(V_(e)),rate constant(K_(ep))and plasma volume fraction(V_(p))were lower in mild defect group than moderate-severe defect group(P<0.05),which were lower in good prognosis group than poor prognosis group(P<0.05).Spearman correlation analysis showed that K^(trans),V_(e),K_(ep) and V_(p) were positively correlated with scores of National Institutes of Health Stroke Scale(NIHSS)and Modified Rankin Scale(MRS).The areas under the curve(AUC values)of K^(trans),V_(e),K_(ep) and V_(p) for predicting the severity of neurological deficits and prognosis of ACI patients were(0.693,0.724,0.660,0.717)and(0.775,0.786,0.776,0.732),respectively.Conclusion:The levels of DCE-MRI quantitative parameters can reflect neural function and prognosis of ACI patients,with significant correlation.