ASL和CTA对前循环大动脉狭窄急性缺血性脑卒中复发的评估

Assessment of Recurrent Acute Ischemic Stroke with Anterior Circulation Great Artery Stenosis by ASL and CTA

目的:探讨ASL及CTA对前循环大动脉狭窄急性缺血性脑卒中复发的预测价值。方法:选取我院收治的前循环大动脉狭窄AIS患者163例,分别进行双时相ASL、CTA、MRI检查。并于一年后进行随访,根据一年后患者MRI结果将患者分为复发组33例和对照组130例。比较两组ASL及CTA检查结果,分析二者对AIS复发的预测价值。结果:与对照组相比较,复发组的rLMC评分、Tan评分、患侧CBF (PLD = 1.5 s)以及患侧CBF (PLD = 2.5 s)均显著低于对照组。多因素Logistic回归分析显示患侧CBF (PLD = 2.5 s)、rLMC评分与急性脑卒中复发独立相关(P 【0.05),二者均对前循环大动脉狭窄急性缺血性脑卒中复发有一定预测价值,二者联合,预测价值最高。ROC曲线下面积为0.862 (95% CI:0.785~0.940,P 【0.05)。结论:ASL及CTA对前循环大动脉急性缺血性脑卒中复发有一定预测价值。

Objective: To investigate the predictive value of ASL and CTA in recurrence of acute ischemic stroke with anterior circulation great artery stenosis. Methods: A total of 163 AIS patients with anterior circulation great artery stenosis in our hospital were selected for dual phase ASL, CTA and MRI examination respectively. The patients were followed up one year later and divided into the recurrence group (33 cases) and the control group (130 cases) according to the MRI results of the patients one year later. The results of ASL and CTA were compared between the two groups to analyze their predictive value for AIS recurrence. Results: Compared with the control group, rLMC score, Tan score, affected side CBF (PLD = 1.5 s) and affected side CBF (PLD = 2.5 s) in the recurrence group were significantly lower than those in the control group. Multivariate Logistic regression analysis showed that affected side CBF (PLD = 2.5 s) and rLMC score were independently correlated with the recurrence of acute ischemic stroke (P <0.05), both of them have certain predictive value for the recurrence of acute ischemic stroke with anterior circulation artery stenosis, and the combination of the two has the highest predictive value. The area under the ROC curve was 0.862 (95% CI: 0.785~0.940, P <0.05). Conclusion: The combination of ASL and CTA has certain predictive value for the recurrence of acute ischemic stroke with anterior circulation great artery stenosis.