The Short-term Prognostic Value Of FLAIR Vascular Hyperintensity In Acute Middle Cerebral Artery Occlusion

Objective:The purpose of this study is to explore the short-term prognostic value of FLAIR vascular hyperintensity in acute middle cerebral artery occlusion and to provide a basis for its clinical application.Methods:There were 41 patients with segment acute occlusion of the middle cerebral artery From January 2017 to November 2019,who received stent thrombolysis in the department of neurology stroke center of the fourth affiliated hospital of China medical university.Finally,forty-one patients were enrolled in the study,and mean age was 66.0(±11.2)years.Collect their clinical data.According to the difference of NIHSS scores,patients were divided into two groups: good short-term prognosis(≥ 4 scores)and poor prognosis(< 4 scores).Clinical dates were obtained and compared with different groups of short-term prognosis.FVH-ASPECTS was evaluated according to distal middle cerebral artery-ASPE CT area(M1–M6).Patients were divided into four groups according to FVH-ASPECTS: FVH negative(0 scores),absent FVH(1-2scores),subtitle FVH(3-4 scores)and prominent(5-17 scores)group.Clinical dates were obtained and compared with different groups of FVH.Quantitative date that accotds with normal distribution is presented by average and standard deviation,otherwise it’s presentedby frequenc y and constituent ratio.Two groups of quantitative date are compared with ch i-square distribution is compared with t test andvariance analysis,while two gro ups of date that is not accord with normal distribution are compared with Mann-Whitney U test.Using Kruskal-Wallis Test and Wilcoxon test to compare multiplegroups thatinconsistent with normal distribution.P<0.05 indicates that the data is statist ically significant.Results: There were 1(20.00%),4(28.57%),4(44.44%)and 10(76.92%)cases of diabetes in FVH Negative Group(n=5),Mild Expression Group(n=14),moderateExpression Group(n=9)and High Expression Group(n=13).The proportion of diabetes Mellitus was significantly higher in the high expression group.The FVH High Expression Group combination with diabetes was 76.92%,which was significantly higher.There was significant difference in the proportion of diabetes mellitus among the groups(P<0.05).There was no significant difference in the constituent ratio of other indexes in each group(P>0.05).The related factors of prognosis were analyzed.The group with good prognosis(n=23)and the group with bad prognosis(n=18)were divided into two groups.The median of collateral circulation grade in the group with good prognosis was 3.0,the median score of FVH was 4.5,the median score of collateral circulation was 0.0 and the median score of FVH was 2.0 in the poor prognosis group.The collateral circulation and FVH-ASPECTS were significantly different between the two groups(p < 0.05).There was no significant difference between the two groups(P>0.05)The short-term prognostic of patient in the treatment of acute middle cerebral artery occlusion with mechanical thrombectomy was associated with FVH-ASPECTS and collateral circulation.FVH-ASPECTS andcollateral circulation were significantly correlated(r=0.739,P=0.000).Evaluation value of FVH on short-term prognosis of acute middle cerebral artery occlusion,the results showed that the discharge NIHSS scores of FVH negative group,mild expression group,moderate expression group and high expression group were 5.0(5.0-9.0),11.0(3.0-22.0),4.0(4.0-8.0),3.0(2.0-4.0),respectively,the difference between discharge and admission NIHSS scores of each group were 0.0(0.0-0.0),1.0(-1.0-2.0),7.0(3.0-15.0),8.0(2.0-9.0).The discharge NIHSS score and the difference between discharge and admission NIHSS score appeared different in all FVH groups(P<0.05).There was no significant difference in the admission NIHSS scores between the groups.Conclusion: Distal FVH was observed 37(88%)of the 41 enrolled patients.FVH-ASPECTS have a good consistency with ASITN/SIR Collateral Flow Grading System.The higher the FVH-ASPECTS score,the higher the level of Collateral Flow Grading.Higher FVH-ASPECTS is associated with good clinical short-term prognostic in patients in the treatment of acute middle cerebral artery occlusion with mechanical thrombectomy.