The Application Value Of Predicting Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage With Whole-brain Three-dimension Arterial Spin-labeling

Object: To explore early clinical predictive value of magnetic resonance three-dimension arterial spin labeling(3D ASL),in delayed cerebral ischemia after subarachnoid hemorrhage caused by aneurysm rupture.Methods: 1.Retrospectively analyzing clinical data in the patients of aneurismal subarachnoid hemorrhage(aSAH),all the patients underwent magnetic resonance on days 3~14 d.Follow up 3 months after postoperation and all patients were divided into DCI group and non-DCI group.In addition,during the same period,10 cases of aneurysm no-repture hemorrhage patients were selected as control group.2.All cases of the original data import GE MR ADW4.6 workstation after motion correction and noise reduction processing,using image post-processing software of Functool,based on cerebral blood flow area,and combining with the zone of cerebral blood flow perfusion abnormalities,to obtain cerebral blood flow perfusion parapeter values.3.Using SPSS 19.0 statistical software to analyze data.Results: 1.Of 30 patients with aSAH,DCI observed in 11 patients,Non-DCIobsreved in 19 patients.The incidence of DCI is36.7%.DCI group with early clinical critical conditions(Fisher3~4)was significantly higher proportion of Non-DCI group.2.Differences tested between 3 groups in degree of cerebral blood flow perfusion abnormalities,and the difference is statistically significant(Chi-Square=17.540,P=0.000).The degree of cerebral perfusion and mRS score was significantly positive correlation(r=0.955,P=0.000).In patients of SAH,the lowered cerebral blood flow perfusion(CBF),the higher the risk of DCI.3.Logistic multivariate regression analysis shows the extent of CBF reduction(OR,0.453;95%CI,0.23~0.86;P0.017),and Fisher classification(OR,0.127;95% CI,0.028~0.567;P 0.007)are risk factors of DCI,significantly correlated with the incidence of DCI.4.Receptor operation curve(ROC)showed the CBF value to the DCI predictive value is not determined,AUC of the CBF ratio and AI value is 0.907 > 0.9,P values < 0.05,with statistical significance,suggesting the DCI early diagnosis value is higher.Conclusion: 3D ASL,an effectice supplement for the conventional cerebral perfusion technique,may be an early useful tool to identify patients at higher risk to develop DCI after SAH.