摘要
目的探讨双参数动脉自旋标记(arterial spin labeling imaging,ASL)成像对急性缺血性卒中(acute ischemic stroke,AIS)侧支循环和预后评估的应用价值。材料与方法回顾性分析2020年6月至2021年7月南京市第一医院神经内科收治的35例AIS患者的多模态MRI和数字减影血管造影(digital subtraction angiography,DSA)数据。根据梗死灶在双反转时间(inversion time,TI)(1500 ms、2510 ms)的ASL灌注情况,将AIS患者分为3组:早期高灌注组(G1,n=8)、晚期高灌注组(G2,n=6)及非高灌注组(G3,n=21)。采用美国介入和治疗神经放射学学会/介入放射学学会(American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology,ASITN/SIR)侧支循环评价系统对侧支循环状态进行评估(侧支循环良好:3~4级;侧支循环不良:0~2级),采用改良Rankin量表(modified Rankin scale,mRS)对出院后3个月预后进行评估(预后良好:≤2分;预后不良:>2分)。最后,应用统计学方法分析3组患者侧支循环差异及预后情况。结果与G3组相比,G1和G2组的入院美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分较低(G1:2.38±1.69;G2:7.33±1.37;G3:14.81±4.86)、侧支循环良好比例较高(G1:100.00%;G2:83.33%;G3:38.10%)、预后良好比例较高(G1:100.00%;G2:50.00%;G3:42.86%)。G1组和G2组两组侧支循环良好比例无明显差异(100.00%vs.83.33%;P=0.180),但G1组预后良好率明显高于G2组(100.00%vs.50.00%;P=0.013)。Spearman相关分析显示G1、G2、G3三组与侧支循环分级呈正相关(r=0.720;P<0.001),与预后mRS评分呈负相关(r=-0.843;P<0.001)。结论双TI的ASL成像能有效评估AIS患者侧支循环状况和预后情况,为临床制订治疗决策提供了重要依据。
Objective:To explore the value of arterial spin labeling(ASL)imaging with dual parameters in evaluating the collateral circulation and prognosis for patients with acute ischemic stroke(AIS).Materials and Methods:From June 2022 to July 2022,multi-modal MRI and digital subtraction angiography(DSA)data of 35 AIS patients from Nanjing First Hospital were retrospectively analyzed.All patients were divided into three groups:high perfusion at early stage group(G1,n=21),high perfusion at later stage group(G2,n=8)and no-high perfusion group(G3,n=6)based on the ASL[inversion time(TI)=1500 ms,2510 ms]imaging features of the infarct lesions.Collateral circulation was divided into good collateral circulation(grade 3-4)and poor collateral circulation(grade 0-2)according to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology(ASITN/SIR).The prognosis was divided into good outcome(≤2 points)and poor outcome(>2 points)according to modified Rankin Scale(mRS)at 3-month follow-up.The differences of collateral circulation and prognosis among three groups were analyzed using statistical methods.Results:Compared with G3,G1 and G2 had lower National Institutes of Health Stroke Scale(NIHSS)score,better collateral circulation and good outcome.There was no significant difference in the collateral circulation between G1 and G2(100.00%vs.83.33%;P=0.180),while the rate of good outcome in G1 was significantly higher than that in G2(100.00%vs.50.00%;P=0.013).Spearman correlation analysis showed that G1,G2,G3 were positively correlated with collateral circulation grade(r=0.720;P<0.001),and negatively correlated with prognosis mRS score(r=-0.843;P<0.001).Conclusions:ASL imaging with double inversion time could effectively evaluate the collateral circulation and prognosis of AIS patients,and provide vital evidence for therapeutic decision-making.
作者
姜海龙
苏文
陈慧铀
陈宇辰
陈国中
殷信道
JIANG Hailong;SU Wen;CHEN Huiyou;CHEN Yuchen;CHEN Guozhong;YIN Xindao(Department of Radiology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China)
出处
《磁共振成像》
CAS
CSCD
北大核心
2023年第3期53-57,80,共6页
Chinese Journal of Magnetic Resonance Imaging
基金
国家自然科学基金(编号:82001811)
江苏省自然科学基金(编号:BK20201118)。
关键词
急性缺血性卒中
双参数
动脉自旋标记
磁共振成像
侧支循环
预后
acute ischemic stroke
dual parameters
arterial spin labeling
magnetic resonance imaging
collateral circulation
prognosis