磁共振IVIM序列与单侧大脑中动脉闭塞所致急性大面积脑梗死的临床预后相关性分析

Correlation between magnetic resonance IVIM sequence and clinical prognosis of acute large area cerebral infarction caused by unilateral middle cerebral artery occlusion

目的探讨磁共振体素内不相干运动(IVIM)序列与单侧大脑中动脉(MCA)闭塞所致急性大面积脑梗死(ACI)临床预后的相关性。方法选取我院80例单侧MCA闭塞所致大面积ACI患者的临床资料,均接受IVIM检查,所有患者出院后90天进行随访管理,通过mRS评分进行预后评估,比较不同预后患者IVIM检查参数(ADC值、f值、D值、D^(*)值),分析IVIM检查参数(ADC值、f值、D值、D^(*)值)与ACI预后的关联性。结果两组性别、年龄、发病至MRI检查用时、吸烟情况、饮酒情况、高血脂、糖尿病、房颤、高血压情况差异无统计学意义(P>0.05),预后不良组入院时NIHSS分值高于预后良好组,差异有统计学意义(P<0.05)。不同预后患者D^(*)值间差异无统计学意义(P>0.05),预后不良患者ADC值、f值、D值低于预后良好患者,差异有统计学意义(P<0.05)。经Pearson检验证实,D^(*)值与ACI预后无显著相关性(P>0.05),ADC值、f值、D值与ACI预后存在显著正相关关系(P<0.05)。结论磁共振IVIM序列相关检查参数与单侧MCA闭塞所致ACI具有密切关联性,可通过IVIM检查对患者预后情况进行诊断评估,从而指导临床开展后续干预。

Objective To investigate the correlation between magnetic resonance voxel incoherent motion(IVIM)sequences and the clinical prognosis of acute large area cerebral infarction(ACI)caused by unilateral middle cerebral artery(MCA)occlusion.Methods A retrospective selection was conducted on the clinical data of 80 patients with unilateral MCA occlusion causing extensive ACI in our hospital.All patients underwent IVIM examination and were followed up for 90 days after discharge.Prognostic evaluation was conducted using mRS score.The IVIM examination parameters(ADC value,f value,D value,D*value)of patients with different prognosis were compared,and the correlation between IVIM examination parameters(ADC value,f value,D value,D^(*)value)and ACI prognosis was analyzed.Results There was no significant difference between the two groups in terms of gender,age,time from onset to MRI examination,smoking,alcohol consumption,hyperlipidemia,diabetes,atrial fibrillation,and hypertension(P>0.05).The NIHSS score at admission in the poor prognosis group was higher than that in the good prognosis group(P<0.05).There was no significant difference in D^(*)values among patients with different prognosis(P>0.05),while the ADC values,f values,and D values of patients with poor prognosis were lower than those of patients with good prognosis(P<0.05).According to Pearson's test,there was no significant correlation between D^(*)value and ACI prognosis(P>0.05),while,ADC value,f value,and D value were significantly positively correlated with ACI prognosis(P<0.05).Conclusion There is a close correlation between the parameters related to magnetic resonance IVIM sequence and ACI caused by unilateral MCA occlusion.IVIM examination can be used to diagnose and evaluate the prognosis of patients,thus guiding clinical follow-up interventions.