ABCD^(3)评分联合3D-ASL低灌注面积评估TIA患者短期发生脑梗死的价值

Predictive value of ABCD^(3) score combined with 3D-ASL for short-term cerebral infarction in patients with TIA

目的探讨ABCD^(3)评分联合三维动脉自旋标记(3D-ASL)灌注成像评估短暂性脑缺血发作(TIA)患者7 d、90 d发生脑梗死的价值。方法纳入77例TIA患者,所有患者2 h内进行ABCD^(3)评分,依据评分分为高危组、中危组、低危组。所有患者48 h内进行磁共振灌注成像检查,依据灌注面积分为3组:低灌注最大面积>3 cm^(2)组,低灌注最大面积<3 cm^(2)组,无低灌注组。对患者进行随访,记录7 d、90 d是否发生脑梗死。分析ABCD^(3)评分联合3D-ASL低灌注面积评估方法、单独ABCD^(3)评分评估方法或3D-ASL低灌注面积评估方法的预测价值。结果与低危组患者比较,中危组、高危组7 d、90 d内脑梗死发生率高,与无低灌注患者比较,低灌注面积>3 cm^(2)的TIA患者脑梗死发生率高。对于TIA患者7 d内、90 d发生脑梗死的评估,联合检测更优。结论ABCD^(3)评分中危组、高危组及低灌注面积>3 cm^(2)是TIA患者早期发生脑梗的风险因素,ABCD^(3)评分联合3D-ASL低灌注面积能更有效且准确预测TIA患者脑梗死的早期进展。

Objective To discuss the value of ABCD^(3) score combined with three-dimensional arterial spin labeling(3D-ASL)in assessing the occurrence of cerebral infarction in patients with transient ischemic attack(TIA)at 7 days and 90 days.Methods This study included 77 patients,ABCD^(3) score and 3D-ASL were assessed within time range,and then according to the score and perfusion area,the subjects were divided into 3 groups.The subjects were followed up and recorded whether cerebral infarction occurred in 7 days and 90 days.Finally,the predictive value of different evaluation methods based on the ABCD^(3) score combined with the 3D-ASL low perfusion area evaluation method and the ABCD^(3) score evaluation method or the 3D-ASL low perfusion area evaluation method alone were analyzed.Results Compared with patients in the low-risk group,the middle-risk group and the high-risk group had a higher incidence of cerebral infarction within 7 days and 90 days.Compared with patients without hypoperfusion,the incidence of cerebral infarction in TIA patients with a low perfusion area greater than 3 cm^(2) was higher.For the prediction of cerebral infarction in patients with TIA within 7 days and 90 days,combined detection was better than single detection.Conclusion The ABCD^(3) score in the middle-risk group,the high-risk group and the low perfusion area greater than 3 cm^(2) are risk factors for early cerebral infarction in TIA patients.The ABCD^(3) score combined with 3D-ASL low perfusion area can more effectively and accurately predict the early progression of cerebral infarction in TIA patients.