The Study Of Magnetic Resonance Perfusion Imaging In Arterial Spin Labeling Of Patients With Early Depression After First Stroke

Objectives To analyze the changes of cerebral perfusion level in patients with early depression after first-episode acute pre-circulation ischemic stroke and to explore the mechanism of early depression after first-episode acute pre-circulation ischemic stroke.Methods According to Hamilton Depression Scale-24 scores,seventy-eight patients with first-episode acute pre-circulation ischemic stroke were divided into post-stroke depression group(44 cases)and post-stroke non depression group(34 cases).All cases were diagnosed and identified by computed tomography(CT)and magnetic resonance diffusion-weighted imaging(MRI-DWI);intracranial blood supply artery distribution and stenosis were determined by magnetic resonance angiography(MRA).Using 3D pseudo-continuous arterial spin labeling(3D-p CASL)perfusion imaging technology,post label delay(PLD)of 1.5s and 2.5s were used to detect cerebral blood flow(CBF).Results(1)There was no significant difference in general data between the PSD group and the non-PSD group(P>0.05).(2)There were statistically significant differences in the proportion of patients with MCA,ACA and ICA≥1 and≥2 at the lesion side between the PSD group and the non-PSD group(χ~2=33.949、6.898,P<0.01);There were significant differences in the proportion of patients with moderate to severe stenosis/occlusion in MCA or ICA at the lesion side between the PSD group and the non-PSD group(χ~2=23.985、8.045,P<0.01).(3)There was significant difference in the proportion of patients with≥2 infarcts focus in different brain regions between the PSD group and the non-PSD group(χ~2=7.104,P<0.01);The difference was statistically significant between the PSD group and the non-PSD group in the proportion of infarcts in the centrum ovale(χ~2=4.722,P<0.05).(4)The difference between the PSD group and the non-PSD group of CBF for PLD1.5s was statistically significant of hypoperfusion regions in the frontal lobe,parietal lobe(t=-3.769,-5.492,P<0.01);The difference between the PSD group and the non-PSD group of CBF for PLD2.5s was statistically significant after the compensation of hypoperfusion regions in the frontal lobe,parietal lobe and temporal lobe(t=-5.761-7.443,-3.110,P<0.01);The CBF of hypoperfusion regions in the frontal lobe,parietal lobe for PLD1.5s and the compensation of hypoperfusion regions in the frontal lobe,parietal lobe and temporal lobe for PLD2.5s were negatively correlated with HAMD scores(r=-0.693、-0.658、-0.768、-0.764、-0.570,P<0.05).Conclusions(1)Multiple cerebral infarcts or centrum ovale infarcts were more common in patients with early depression after first-episode acute pre-circulation ischemic stroke.(2)The lower perfusion level of the PLD1.5s,the more severe depression of the post-stroke depression;the worse the collateral circulation compensation of the PLD2.5s,the more severe depression of the post-stroke depression;(3)The hypoperfusion regions on the lesion side of frontal lobe,parietal lobe and temporal lobe and the insufficient compensation of collateral circulation may be involved in the occurrence and development of early depression after first-episode acute pre-circulation ischemic stroke.Figure 4;Table12;Reference 112...