DWI及3D-ASL定量参数对AIS患者血管内治疗预后的预测价值  

Predictive value of DWI and 3D-ASL quantitative parameters on the prognosis of endovascular treatment of AIS patients

作　　者：于冬洋 赵正宇 韩雷 胡丽丽 陶剑 柳勇 YU Dongyang;ZHAO Zhengyu;HAN Lei;HU Lili;TAO Jian;LIU Yong(Huai’an Hospital Affiliated to Xuzhou Medical University,Huai’an 223002,China)

机构地区：[1]徐州医科大学附属淮安医院,江苏淮安223002

出　　处：《中国实用神经疾病杂志》2025年第3期289-293,共5页Chinese Journal of Practical Nervous Diseases

基　　金：淮安市卫生健康科研项目(编号:HAWJ202116)。

摘　　要：目的分析弥散加权成像(DWI)及三维动脉自旋标记(3D-ASL)定量参数对急性缺血性脑梗死(AIS)患者血管内治疗预后的预测价值。方法回顾性选取徐州医科大学附属淮安医院2020-10—2023-10治疗的AIS患者81例,均接受血管内治疗及DWI、3D-ASL检查,按出院后随访预后情况分为A组(n=43)和B组(n=38),对比2组临床资料、DWI及3D-ASL定量参数[表观弥散系数(ADC)、脑血流量(CBF)及对侧相对的rADC、rCBF],分析DWI及3D-ASL定量参数与AIS患者病情严重程度的相关性及对预后的预测价值。结果A组梗死面积和NIHSS评分均明显低于B组(P<0.05)。A组ADC、CBF及rADC、rCBF均明显高于B组(P<0.05)。Pearson相关分析显示,ADC和rADC与AIS患者梗死面积呈负相关(P<0.05),ADC、CBF及rADC、rCBF与AIS患者NIHSS评分呈负相关(P<0.05)。ROC曲线显示,ADC、CBF及rADC、rCBF预测AIS患者血管内治疗预后均有较高价值(AUC=0.779、0.669、0.646、0.754),联合预测价值更高(AUC=0.881)。结论DWI及3D-ASL定量参数与AIS患者病情严重程度相关,在预测患者血管内治疗预后方面具有重要价值。Objective To analyze the predictive value of diffusion-weighted imaging(DWI)and three-dimensional arterial spin labeling(3D-ASL)quantitative parameters on the prognosis of endovascular treatment of patients with acute ischemic stroke(AIS).Methods Eighty-one patients with AIS in the Huai’an Hospital Affiliated to Xuzhou Medical University from October 2020 to October 2023 were retrospectively selected.All the patients received endovascular treatment and DWI and 3D-ASL examination.According to the follow-up prognosis after discharge,they were classified into A group(n=43)and B group(n=38).The clinical data,DWI and 3D-ASL quantitative parameters(apparent diffusion coefficient(ADC),cerebral blood flow(CBF)and contralateral relative ADC,CBF)were compared between both groups.The correlation between DWI and 3D-ASL quantitative parameters and the disease severity of AIS patients and their predictive value on prognosis were analyzed.Results The infarction size and NIHSS score in A group were significantly lower than those of B group(P<0.05),while the ADC,CBF and rADC,rCBF were significantly higher compared to B group(P<0.05).Pearson analyses showed that ADC and rADC were negatively correlated with infarction size in AIS patients(P<0.05),and ADC,CBF and rADC,rCBF were negatively correlated with NIHSS score in AIS patients(P<0.05).ROC curve showed that ADC,CBF and rADC,rCBF had high value on predicting the prognosis of endovascular treatment in AIS patients(AUC=0.779,0.669,0.646,0.754,respectively),and the combined predictive value was higher(AUC=0.881).Conclusion DWI and 3D-ASL quantitative parameters are related to the disease severity of AIS patients,and have important value on predicting the prognosis of patients with endovascular treatment.

关 键 词：急性缺血性脑梗死 血管内治疗 弥散加权成像 三维动脉自旋标记 定量参数 预后 预测价值 

分 类 号：R743.33[医药卫生—神经病学与精神病学]