The Value Of Arterial Spin Labeling And Susceptibility Weighted Imaging In The Diagnosis And Prognosis Of Acute Cerebral Infarction

Objective:By applying the ASL and SWI imaging techniques,to analyse the patients with acute ischemic stroke images,to explore whether it can evaluate the diagnosis and prognosis of ischemic cerebral apoplexy patients to provide new insights,eventually improve the clinical prognosis of patients.Materials and methods:In this study we retrospective analysis 32 acute cerebral infarction patients in January 2017-January 2018 which occurred within 48 hours from onset to accept MR check.The conventional MRI,SWI and 3D-ASL were performed on all subjects by using Siemens 3.0T MR imaging system.Through post-processing software for minimum intensity projectio(mIP)and rCBF pseudo color map figure By using threshold of 20%,we divided the patients into 3 groups according to the degree of the infarction and the surrounding area rCBF: hyperperfusion(ipsilateral and contralateral r CBF ratio>120%),and iso-perfusion(ipsilateral and contralateral r CBF ratio in the 80% to120%)and hypoperfusion(ipsilateral and contralateral rCBF ratio <80%).We defined high perfusion signal existed in the ASL images that surrounding the infarction area as Perilesional hyperperfusion(PLH).32 patients of acute cerebral infarction,according if high perfusion signal existed in the ASL images that surrounding the infarction core area,were divided into the PLH group and the control group.To calculated the relationship among PLH and the day of admission NIHSS scores,and recent prognosis using the statistics respectively.To observed the distribution and degree of abnormal vein surrounding the infarcts on SWI-mIP.To calculated the relationship among abnormal venous degree and the day of admission NIHSS scores,and recent prognosis respectively.In addition,we analyzed the imaging findings of ASL and SWI image.To assess the relationship between the blood perfusion situation in periphery of acute cerebral infarction and degree of abnormal vein surrounding the infarcts and degree of abnormal vein,as well as the blood perfusion status of periphery.Result:(1)Acute cerebral infarction lesions showed high signal intensity on DWI and low signal on ADC in all 32 patients,In 27 out of 32 patients had abnormal perfusion in infraction region,hyperperfusion in 1 patients,lower perfusion in 26 patients.In 15 out of 32 patients had abnormal perfusion in peri-infarction region,hyperperfusion in 7 patients,lower perfusion in 8 patients.So PLH group had 7 cases(7/32,21.9%)and control group had 25 cases.PLH was associated with the day of admission NIHSS scores and recent prognosis(P<0.05).(2)SWI demonstrated veins increase and dilatation in peri-infarcted region in 15 patients.Vein distribution around the acute infarcts area was significant increase and dilatation in 6 patients and slight increase in 9 patient.In addition,The correlation between the degree of abnormal vein and the day of admission NIHSS scores had no statistical significance(P>0.05).The degree of abnormal vein and recent prognosis(P<0.05).(3)In 6 out of 7 PLH group cases had no abnormal vein distribution aroud infarcts region,remaining 1 cases were in grade 1 change.The blood perfusion situation in periphery of acute cerebral infarction had relationship with the degree of abnormal vein distribution aroud infarcts area(P<0.05).Conclusion:(1)Our study revealed that ASL imaging can be used to capture post-ischaemic PLH patterns in acute cerebral infarction patients.PLH is associated with good collaterals or revascularization.PLH prompts good recent prognosis.(2)SWI image can show abnormal vien distribution of acute cerebral infarction.Displaying of abnormal veins distribution around the infarction indirectly reflects the state of the blood perfusion and cell metabolic state of ischemic brain tissue.Increasing significantly of abnormal veins distribution prompts severe degree of vascular stenosis,severe neurologic deficits and poor recent prognosis.(3)MRI imaging combined with ASL as well as SWI,can be more objective prompt hemodynamic information around the acute cerebral infarction region.They are without the contrast,strong repeatability and provide more information in patients condition,therapy and progronostic evaluation.