| purposeIn this study,arterial spin labeling(ASL)magnetic resonance imaging(MRI)was used to evaluate the level of intracranial infarction relative to cerebral blood flow in AIS patients,and to explore the relationship between infarct perfusion and patient prognosis in AIS patients.It also evaluates the low-perfusion rCBF critical value that predicts poor prognosis of patients with AIS,and aims to provide useful clues and basis for predicting the prognosis of patients and guiding treatment.Materials and methods:From December 2017 to August 2020,the Department of Neurology,Subei People’s Hospital of Jiangsu Province,was diagnosed with acute ischemic stroke patients,all of whom obtained clear diffusion-weighted imaging(DWI)and ASL within 72 hours of onset image.The CBF value of the lesion at the largest level of DWI cerebral infarction was compared with the CBF value of normal brain tissue in the same layer of the same layer to obtain the relative cerebral blood flow(rCBF),with rCBF>120%,120≥rCBF > 80% and rCBF≤80%,121 patients were divided into high perfusion group,normal perfusion(no significant change in perfusion)group and low perfusion group.A mRS score of 0-2 points after 3 months is defined as a good prognosis,and an mRS score of >2 is defined as a poor prognosis.According to whether the prognosis is good or not,the baseline data is analyzed by t-test and chi-square test;the correlation between different cerebral perfusion levels and prognosis,and the correlation between different etiological types and cerebral perfusion levels are analyzed by chi-square test;through dual logistics Regression analysis of related risk factors for the prognosis of AIS patients;ROC curve analysis of the predictive value of cerebral perfusion level on the prognosis of patients.result:A total of 121 patients were enrolled in this study,of which 77 had a good prognosis and 44 had a poor prognosis.The baseline data analysis of the two groups showed that age(P=0.006),atrial fibrillation(P=0.008),neutrophil percentage(P =0.003),triglyceride level(P=0.034),NIHSS score at admission(P=0.001),TOAST classification(P=0.002),and perfusion level(P=0.001)have statistically significant effects on the prognosis;Binary logistics regression analysis showed that males(OR,0.030;95% CI,0.068-1.052;P=0.030),NIHSS admitted to hospital(OR,1.414;95%CI,1.201-1.664;P=0.001),low perfusion(OR,6.331;95% CI,1.615-24.811;P=0.008)is an independent influencing factor of AIS patients;ROC curve analysis shows that the area under the ROC curve for rCBF to predict the prognosis of cerebral infarction is 0.715(P=0.000;95% confidence interval,0.612-0.818).The optimal cutoff value of rCBF for predicting the prognosis of cerebral infarction is 76.99%,the sensitivity is 69.6%,and the specificity is 73.7%in conclusion:The hypoperfusion of the infarct in AIS patients is related to the poor prognosis of 3months.Relative cerebral blood flow(rCBF)can provide certain reference value in predicting the prognosis of AIS patients... |
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