ADC值在急性脑梗死预后评估中的应用  

Application of ADC value in prognosis assessment of acute cerebral infarction

作　　者：葛宏艳 张丽萍 陈荟 许凤 邢慧宇 花村 GE Hongyan;ZHANG Liping;CHEN Hui;XU Feng;XING Huiyu;HUA Cun(Department of Radiology,Yancheng Hospital of Traditional Chinese Medicine,Yancheng 224000,China)

机构地区：[1]江苏省盐城市中医院放射科,江苏盐城224000

出　　处：《中国中西医结合影像学杂志》2021年第5期443-445,共3页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:探讨DWI的ADC值在急性脑梗死预后评估中的临床应用价值。方法:回顾性分析48例随访时间>90 d的单侧前循环急性脑梗死患者的资料。根据随访90 d改良Rankin(90 d mRS)评分,将其分为预后良好组(A组)28例和预后较差组(B组)20例。选取病灶及对侧正常脑组织为ROI,测量各ROI的ADC值,并计算病灶/对侧相对ADC(rADC)值。比较2组间病灶与对侧ADC值及rADC值的差异。分析rADC值区分2组的最佳诊断界值和诊断效能。rADC值与患者预后(90 d mRS评分)行相关性分析。结果:2组病灶ADC值均明显低于对侧正常脑组织(均P<0.001)。B组病灶ADC值和rADC值均明显低于A组(均P<0.05)。rADC值区分2组的最佳诊断界值是0.52,对应的敏感度、特异度和约登指数分别为67.9%、85.0%和0.529。rADC值与患者90 d mRS评分呈明显负相关(r=-0.684,P<0.001)。结论:rADC值与急性脑梗死的预后具有相关性,可用于对该病的预后评估。Objective:To evaluate the application of ADC value of DWI in the prognosis assessment of acute cerebral infarction.Methods:The data of 48 patients with unilateral anterior circulation acute cerebral infarction followed up for more than 90 d were retrospectively analyzed.According to the modified Rankin scale score after 90 days of follow-up(90 d mRS score),patients were divided into two groups with good prognosis(Group A,28 cases)and poor prognosis(Group B,20 cases).Lesions and contralateral normal brain tissue were selected as ROI,and ADC values were measured,and relative ADC(rADC)values of lesions/contra were calculated.The differences of ADC of lesions and contra and rADC values between the two groups were compared.The rADC value was used to determine best diagnostic threshold and diagnostic efficiency in distinguishing Group A and B.The correlation between rADC value and 90 d mRS score was analyzed.Results:ADC values of lesions in both groups were significantly lower than those of the contralateral side(both P<0.001).The ADC value of lesion and rADC value in Group B were significantly lower than those in Group A(both P<0.05).The best diagnostic threshold of rADC value for distinguishing Group A and B was 0.52,with the sensitivity,specificity and Youden indexe of 67.9%,85.0%and 0.529,respectively.The rADC value was significantly negatively correlated with 90 d mRS score(r=-0.684,P<0.001).Conclusions:The rADC value is correlated with AMI prognosis,which can be used to evaluate the prognosis.

关 键 词：磁共振成像 扩散 大脑梗塞 

分 类 号：R743.33[医药卫生—神经病学与精神病学]