基于动脉自旋标记灌注成像指标预测缺血性脑卒中患者预后的研究

Arterial spin labeling MRI in the outcome prediction of

ischemic stroke patients

Abstract

Objective:

Ischemic stroke is a serious disease that threatens human health,The incidence rate of it is increasing year by year.The most common cause is cerebrovascular stenosis or occlusion.To explore the value of arterial transit artifact(ATA),a characteristic sign of arterial spin labeling perfusion imaging(ASL),in predicting the prognosis of patients with symptomatic cerebrovascular stenosis or occlusion;At the same tim,as a standard,to compare the consistency between arterial spin labeling perfusion imaging and DSC-PWI in the hemodynamic evaluation of these patients.

Methods:

A total of40patients with symptomatic cerebrovascular stenosis or occlusion who were treated at the Department of Neurology of the Jincheng General Hospital between September2016and December2017were recruited and confirmed by DSA,CTA or MRA.There were26males and14females,aged36～81years,with an average age of 57±14years.Record patient's general information in detail,such as name,gender, whether there is a risk factor for stroke,etc.All patients completed routine MRI,DWI, MRA,and ASL scans.12patients of those underwent DSC-PWI scan.Through follow-up of patients for one year,grouped these patients according to the follow-up results whether they had an ischemic event,compared baseline clinical and imaging indicators of two groups,and judged whether these indicators are related to the prognosis of patients.At the same time,compared the consistency of ASL and DSC-PWI on evaluating cerebral hemodynamics.The imaging indicators analysis was judged by two neuroimaging

physicians independently and blindly.When they had arguments about the same image,they gave same results by discussing.

Results:

In40patients,a total of23patients(57.5%)had high cortical bright signals in the ASL cerebral blood flow map.According to the results of follow-up,there were12 patients(30%)with recurrent ischemic events and28patients(70%)without recurrent ischemic events.Of these,there are4patients(33.3%)who had arterial transit artifacts in the ASL map with12patients with recurrent ischemic events and the remaining8cases did not show this sign;in patients with no recurrent ischemic events,there were19 patients(67.9%)with high signal in the ASL map.There was a significantly statistical difference between the two groups(P<0.05),This shows that arterial transit artifacts in the ASL cerebral blood flow map are more common in patients with good prognosis, indicating that arterial transit artifacts can help predict the prognosis of patients.

Conclusion：

Arterial transit artifacts,the characteristic signs of arterial spin labeling perfusion imaging,may serve as an indicator of prognosis in patients with ischemic stroke.

Key words:Ischemic Stroke;Arterial Spin Labeling;Arterial Transit Artifact;

Pefusion weighted Imaging