基于半暗带缺血区鉴别角度分析多模态MRI在不同时期脑梗死患者诊断中的价值  

Value of multimodal MRI in the diagnosis of cerebral infarction in different periods based on penumbra ischemia differentiation

作　　者：黄海燕[1] 王云玲[1] 黄玉洁[1] 常存 HUANG Haiyan;WANG Yunling;HUANG Yujie;CHANG Cun(The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830063,China)

机构地区：[1]新疆医科大学第一附属医院,新疆乌鲁木齐830063

出　　处：《中国实用神经疾病杂志》2024年第10期1195-1200,共6页Chinese Journal of Practical Nervous Diseases

基　　金：科技部中央引导地方科技专项项目(编号:ZYYD2023D02);新疆维吾尔自治区科技厅“天山英才”科技创新领军人才项目(编号:2023TSYCLJ0027)。

摘　　要：目的基于半暗带缺血区鉴别角度分析多模态MRI在不同时期脑梗死患者诊断中的应用价值。方法选取2021-05—2023-06在新疆医科大学第一附属医院接受检查的198例脑梗死疑似患者,根据发病时间分为A组(发病时间≤4.5 h)、B组(4.5 h<发病时间≤7 d)和C组(7 d<发病时间≤3个月),均接受常规MRI序列、扩散加权成像(DWI)、灌注加权成像(PWI)等多模态MRI技术和DSA检查,以DSA检查结果为金标准,比较常规MRI平扫、DWI和多模态MRI(常规MRI平扫+DWI+PWI)检查对3组脑梗死患者诊断的敏感度、特异度、准确率。制作3种检查方法诊断不同时期脑梗死患者的受试者工作特征(ROC)曲线,测算曲线下面积(AUC)。结果A组52例脑梗死疑似患者,确诊32例;B组103例脑梗死疑似患者,确诊67例;C组43例脑梗死疑似患者,确诊28例。在A组、B组、C组中,常规MRI平扫、DWI、多模态MRI 3种方法对脑梗死的诊断效能均有差异,以多模态MRI的灵敏度、特异度、准确率最高(P<0.05)。A组中常规MRI平扫、DWI、多模态MRI 3种方法诊断脑梗死的ROC曲线AUC值分别为0.6738、0.7642、0.8329,B组分别为0.6857、0.7714、0.8582,C组分别为0.6912、0.7806、0.8629,差异有统计学意义(P<0.05)。结论基于半暗带缺血区鉴别角度分析多模态MRI在不同时期脑梗死患者诊断中具有较高的临床应用价值,能够显著提高灵敏度、特异度、准确率及AUC值,值得推广应用。Objective To analyze the application value of the multimodal MRI in the diagnosis of the patients with cerebral infarction in different periods based on penumbra ischemia differentiation.Methods From May 2021 to June 2023,198 patients with suspected cerebral infarction admitted to the First Affiliated Hospital of Xinjiang Medical University were selected as the study subjects.According to the onset time,the patients were divided into group A(onset time≤4.5 h),group B(onset time>4.5 h-7 d)and group C(onset time>7 d-3 months).All patients successively received conventional MRI sequence,diffusion weighted imaging(DWI),perfusion weighted imaging(PWI)and other multimodal MRI techniques and DSA examination.Using the DSA examination results as the gold standard,the sensitivity,specificity and accuracy of conventional MRI,DWI and multimodal MRI(conventional MRI+DWI+PWI)in the three groups were compared.Receiver operating characteristic(ROC)curves of patients with cerebral infarction at different periods were made with three examination methods,and the area under curve(AUC)was measured.Results Fifty-two patients with suspected cerebral infarction in group A,32 confirmed.One hundred and three patients with suspected cerebral infarction in group B,67 confirmed.Forty-three patients with suspected cerebral infarction in group C,28 confirmed.In group A,B and C,the sensitivity,specificity and accuracy of conventional MRI,DWI and multimodal MRI for diagnosis of cerebral infarction were increased successively,and the difference was statistically significant(P<0.05).In group A,the AUC values of the ROC curves for conventional MRI,DWI and multimodal MRI for diagnosis of cerebral infarction were 0.6738,0.7642 and 0.8329,respectively,in group B which were 0.6857,0.7714 and 0.8582,respectively,and in group C which were 0.6912,0.7806 and 0.8629,respectively.The differences were statistically significant(P<0.05).Conclusion Multimodal MRI based on penumbra ischemia differentiation has high clinical application value in the diagnosis of

关 键 词：脑梗死 半暗带缺血区 多模态MRI 数字减影血管造影 诊断价值 

分 类 号：R743.33[医药卫生—神经病学与精神病学]