The Effect Of PWI With Mismatch Of MTT-TTP And SWI With Prominent Vessel Sign On The Prognosis Of Ischemic Stroke

Background and Purpose:The incidence of ischemic stroke increases year by year.The high disability and mortality of stroke have a significant impact on Family and Social economy^[1,2].Therefore,it is particularly important to treat cerebral infarction actively and understand the prognosis early.Understanding the relationship between pathophysiological change of stoke and prognosis of patients by existing examination techniques early,then to guide the clinical and rehabilitation treatment,and to benefit the patients and their families.Objective:?1?To observe the relationship between PVS on SWI and the prognosis of patients.?2?To observe the relationship between the mismatch of MTT-TTP on PWI and the prognosis of patients.?3?To analyze the correlation between PVS on SWI and the mismatch of MTT-TTP on PWI.?4?To analyze the consistency between PVS and mismatch of MTT-TTP in predicting the prognosis of patients.Material and Methods:?1?Forty-two acute ischemic stroke patients without endovascular therapy in the middle cerebral artery territory were enrolled.All of them come from Department of Neurology,the first Hospital of Jilin University from March to December 2017.Record the general data in detail,such as sex,age of the patients,and the risk factors of cerebrovascular disease such as hypertension,diabetes,hyperlipidemia,uric acid,homocysteine,smoking and so on.Meanwhile record the stenosis degree of middle cerebral artery and the NIHSS score of patients.?2?The SWI and PWI was examined in the 3⁷ days of onset,all patients were divided into PVS group and no PVS group according to the difference number of veins between bilateral hemispheres on SWI.All patients were classified into mismatch group of MTT-TTP and no mismatch group of MTT-TTP according to the difference of area between MTT and TTP on the layer with the maximum perfusion delay,and we consider it is advisable that MTT-TTP/TTP greater than 3%.?3?Clinical outcome was classified as good if the mRS score after three months was?2,otherwise,was classified into poor group.?4?Chi-square test,t test,Kruskal-Wallis test and Logistic regression model were used to analyze the relationship between clinical data,imaging parameters and prognosis of patients.Spearman correlation analysis was used to analyze the correlation between PVS and mismatch of MTT-TTP.Chi-square test was used to analyze the consistency between PVS and mismatch of MTT-TTP in predicting the prognosis of patients.Results:In the 42 stroke patients,there were 25 patients with poor clinical outcome.PVS was observed in 26 patients,21?80.8%?of them had poor outcome.And mismatch of MTT-TTP was observed in 21 patients,18?85.7%?of them had poor outcome.In the poor clinical outcome group,there were 21 of 25?84%?patients with PVS and 18 of 25?72%?with mismatch of MTT-TTP.In the PVS group,mismatch of MTT-TTP was observed in 21 of 26?80.8%?patients.Statistical analysis showed that NIHSS score,mismatch of MTT-TTP were the independent risk factors for poor clinical outcome?NIHSS score OR=3.792,95%CI 1.468-9.797,p=0.006.mismatch of MTT-TTP OR=0.028,95%CI 0.002-0.480,p=0.014?.PVS closely related to mismatch of MTT-TTP??=0.784,p=0.000?.Chi-square test indicated that there is no difference between PVS and mismatch of MTT-TTP to predict prognosis?p>0.65?.Conclusions:The acute stroke patients in the 3⁷ days of onset,PVS on SWI is related with mismatch of MTT-TTP.PVS and mismatch of MTT-TTP reflect poor outcome.And there is no difference between PVS and mismatch of MTT-TTP to predict prognosis.