酰胺质子转移MRI技术在预测急性缺血性脑卒中预后情况的可行性研究  

Study on the feasibility of MRI technique with APT in predicting the prognosis of acute ischemic stroke

作　　者：赵傲 武新英[1] 付彤[1] 王培炎 蒋腾[2] 林海 于慧华 袁健闵 刘林栋[1] Zhao Ao;Wu Xinying;Fu Tong;Wang Peiyan;Jiang Teng;Lin Hai;Yu Huihua;Yuan Jianmin;Liu Lindong(Department of Medical Imaging,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China;Department of Neurology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China;Central Research Institute,Shanghai United Imaging,Shanghai 201800,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)医学影像科,南京210006 [2]南京医科大学附属南京医院(南京市第一医院)神经内科,南京210006 [3]上海联影中央研究院,上海201800

出　　处：《中国医学装备》2024年第1期46-50,54,共6页China Medical Equipment

摘　　要：目的:研究酰胺质子转移(APT)磁共振成像(MRI)技术在预测脑卒中预后情况的可行性。方法:选取2022年9月至2023年5月南京医科大学附属南京医院收治的71例急性脑卒中患者,入院前均进行美国国立卫生研究院卒中量表(NIHSS)评分,并进行化学交换饱和转移(CEST)MRI检查,根据预后1个月随访的调制等级分数(mRS)分为两组,将mRS<2分的患者纳入恢复良好组(44例);mRS≥2分的患者纳入恢复不良组(27例)。分析数据获得不对称磁化转移比(MTRasym)图像的APT,并计算出缺血区和对侧正常组织APT成像信号的差值(△APTw)。对比分析两组△APTw的差异性,采用Pearson相关性分析△APTw与NIHSS及mRS评分之间的相关性。绘制受试者工作特征(ROC)曲线,计算ROC曲线下面积(AUC)。结果:患者图像的△APTw与NIHSS以及mRS评分之间存在显著的正相关(R^(2)=0.659、0.522,P<0.001),恢复良好组与恢复不良组之间的△APTw、NIHSS和mRS评分比较,差异有统计学意义(t=5.73、6.36、13.92,P<0.05)。APT预测脑卒中预后的AUC为0.886,灵敏度和特异度分别为77.8%和95.5%,阳性预测值为91.3%,阴性预测值为87.5%。结论:APT成像技术在预测急性脑缺血性脑卒中的预后情况具有可行性。Objective:To study the feasibility of magnetic resonance imaging(MRI)technique with amide proton transfer(APT)in predicting the prognosis of cerebral stroke.Methods:A total of 71 patients with acute cerebral stroke who admitted to the Nanjing First Hospital,Nanjing Medical University from September 2022 to May 2023 were selected.All of them underwent the test of National Institute of Health Stroke Scale(NIHSS),and received the MRI examination with chemical exchange saturation transfer(CEST).According to the modified Rankin scale(mRS)values of 1-month follow-up,they were divided into favorable recovery group(mRS<2,44 cases)and poor group(mRS≥2,27 cases).The asymmetric magnetization transfer ratio(MTRasym)image(APT)was obtained by analyzing data with special software.And then,the difference(△APTw)of APT values between ischemic zone and contralateral normal tissue was further calculated.The△APTw values of two groups were compared and analyzed,and the Pearson correlation analysis was adopted to analyze the correlation among△APTw,NIHSS and mRS.The receiver operating characteristics(ROC)curve was drawn,and the area under curve(AUC)of ROC curve was calculated.Results:There were significant positive correlations among△APTw,NIHSS and mRS scores(R^(2)=0.659,0.522,P<0.001),and the differences of△APTW,NIHSS and mRS scores between the favorable recovery group and poor group were significant(t=5.73,6.36,13.92,P<0.05),respectively.The AUC value was 0.886,and the sensitivity and specificity of prediction were respectively 77.8%and 95.5%.The positive and negative predictive values were respectively 91.3%and 87.5%.Conclusion:APT imaging technique has feasibility in predicting the prognosis of acute cerebral ischemic stroke.

关 键 词：化学交换饱和度转移(CEST) 酰胺质子转移(APT) 磁共振成像(MRI) 脑卒中 曲线下面积(AUC) 敏感度 特异度 

分 类 号：R445.2[医药卫生—影像医学与核医学]