Correlation Between FVH And ASL In Ischemic Stroke And Its Value In Clinical Prognosis

Objectives This study aims to explore the correlation between FLAIR vascular hyperintensity(FVH)and Arterial spin labeling(ASL),and analyze the value of FVH in evaluating short-term clinical prognosis.Methods Continuous collection of 60 patients with ischemic stroke who were treated in the Department of Neurology of Tangshan worker’s Hospital from October 2019 to December 2021,all patients underwent cranial magnetic resonance scanning,DWI(Diffusion weighted imaging),MRA(Magnetic resonance angiography)and ASL(Arterial spin spin)examination,and collected clinical and laboratory data,including age,gender,smoking,drinking,hypertension,diabetes,hyperlipidemia,hyperhomocysteinemia,atrial fibrillation,previous stroke history.FVH was divided into FVH positive group and FVH negative group according to whether there was FVH.The relationship between the existence of FVH and clinical data,the degree of vascular stenosis and infarct size was compared;41 cases of cerebral infarction with FVH positive and unilateral proximal middle cerebral artery stenosis > 50% were further selected from 60 cases to explore the correlation between FVH-ASPECT score and ATA-ASPECT score and the relationship between FVH score and ASL cerebral perfusion abnormalities,The patients were divided into low group and high group according to the FVH-ASPECT score(bounded by median4),and the scores of National Institutes of Health Stroke Scale(NIHSS)were recorded,The relationship between FVH score grouping and NIHSS score difference in admission,discharge and admission was analyzed.Results 1 In 60 patients with ischemic stroke,there were 44 cases in FVH positive group and 16 cases in FVH negative group.The occurrence of FVH and the collected clinical data were not statistically significant(P>0.05),but correlated with the degree of vascular stenosis(χ~2=18.279,P<0.001),infarct size(χ~2=6.213,P=0.013),and the more severe the vascular stenosis,the larger the infarct area,and the higher the incidence of FVH.In 41 cases of FVH positive group with unilateral MCA stenosis >50%,there was no significant difference between FVH low group and high group and the collected clinical data(P>0.05),and there was no significant difference in infarct size(P>0.05).2 there was a strong correlation between FVH-ASPECT score and ATA-ASPECT score(r=0.852,P<0.001),and the higher FVH-ASPECT score,the higher ATA-ASPECT score,there was a positive correlation between them.3 when the FVH score of ischemic stroke under the ROC curve is ≥3,the sensitivity of judging abnormal cerebral perfusion is 90.6%,the specificity is66.7%,and the area under the curve is 0.878(95%CI: 0.759-0.998,P=0.001).4 there was no significant difference between FVH score and admission NIHSS score(P>0.05),but there was significant difference between FVH score and discharge NIHSS score and admission NIHSS score(P<0.05).Conclusions 1 The presence or absence of FVH has nothing to do with common clinical risk factors(smoking,hypertension,etc.).The degree of vascular stenosis and infarct size are important factors leading to the occurrence of FVH.2 FVH-ASPECT score and ATAASPECT score have good consistency.Although their imaging methods are different,they both reflect slow blood flow and have good correlation in indirect estimation of collateral circulation.3 FVH score can simply replace ASL in the early detection of abnormal perfusion,help clinicians quickly understand the infarct and surrounding cerebral perfusion,and guide clinical treatment.4 FVH score has a certain reference value in evaluating the short-term clinical prognosis of cerebral infarction patients with unilateral MCA proximal stenosis >50%,and the clinical prognosis of patients with high FVH score may be better.Figure 8;Table 5;Reference 124...