磁共振灌注加权成像联合ABCD2评分评估短暂性缺血发作后脑梗死发生风险的价值  

The Value of Perfusion-weighted Magnetic Resonance Imaging Combined with ABCD2 Scoring in Assessing the Risk of Cerebral Infarction after Transient Ischemic Attack

作　　者：王斌[1] 徐雪 姚振威 何光武[1] 王博[3] 黄澄[4] WANG Bin;Xu Xue;YAO Zhen-wei;HE Guang-wu;WANG Bo;HUANG Cheng(Department of Radiology, Baoshan Branch of Shanghai First People's Hospital;Department of Radiology, Huashan Hospital, Fudan University;Department of Neurology, Baoshan Branch of Shanghai First People's Hospital;Department of Emergency, Baoshan Branch of Shanghai First People's Hospital)

机构地区：[1]上海市第一人民医院宝山分院放射科 [2]复旦大学附属华山医院放射科 [3]上海市第一人民医院宝山分院神经内科 [4]上海市第一人民医院宝山分院急诊科

出　　处：《中国医学计算机成像杂志》2018年第6期455-459,共5页Chinese Computed Medical Imaging

基　　金：上海市卫生和计划生育委员会项目项目编号201540285~~

摘　　要：目的:探讨磁共振灌注加权成像(MR-PWI)联合ABCD2评分评估短暂性缺血发作(TIA)后脑梗死发生风险的价值。方法:收集TIA患者97例,在发病后24小时内行MR-PWI及MRI(含DWI)检查。对患者进行ABCD2评分及MR-PWI联合ABCD2评分,一周内复查MRI(含DWI)了解是否有新发脑梗死。采用曲线下面积(AUC)评估并比较两种评分系统对TIA患者一周内发生脑梗死的预测价值,取P<0.05为差异具有统计学意义。结果:TIA患者MR-PWI阳性组一周内脑梗死发生率明显高于阴性组,差异具有统计学意义(χ~2=17.771,P<0.001);MR-PWI联合ABCD2评分低危组、中危组与高危组脑梗死发生率的差异有统计学意义(χ~2=25.999,P<0.001);预测TIA后一周内脑梗死风险时,ABCD2评分及MR-PWI联合ABCD2评分的AUC值分别是0.8469、0.8672,二者差异具有统计学意义(Z=1.9619,P=0.0498)。结论:在预测TIA后患者一周内脑梗死的发生风险时,MR-PWI联合ABCD2评分法准确性高于ABCD2评分法。Purpose: To investigate the value of magnetic resonance perfusion-weighted imaging (MR-PWI) combined with ABCD2 score in assessing the risk of cerebral infarction after transient ischemic attack (TIA). Methods: Ninety-seven patients with TIA were enrolled. MR-PWI and MRI (with DWI) scans were performed within 24 hours after the onset of TIA. At the same time, patients were assessed for ABCD2 scores and MR-PWI combined with ABCD2 scores, and then MRI (including DWI) was reviewed within a week to see whether there were new cerebral infarctions. The area under the curve (AUC) was used to evaluate and compare the predictive value of two scoring systems for cerebral infarction in patients with TIA within one week, and P<0.05 was considered as statistical significant. Results: In TIA patients, the incidence of cerebral infarction in MR-PWI positive group was significantly higher than that in negative group (χ^2=17.771, P<0.001). There was a significant difference in the incidence of cerebral infarction between the low-risk group, the intermediate-risk group and the high-risk group (P<0.05). When predicting the risk of cerebral infarction within one week after TIA, there was a significant difference between the AUC value of ABCD2 score and the MR-PWI combined with ABCD2 score, which were 0.8469 and 0.8672 (Z=1.9619, P=0.0498). Conclusion: When predicting the risk of cerebral infarction within one week after TIA, the accuracy of MR-PWI combined with ABCD2 score is higher than that of ABCD2.

关 键 词：磁共振成像 灌注加权成像 ABCD2评分 短暂性脑缺血发作 脑梗死 

分 类 号：R445.2[医药卫生—影像医学与核医学]