Prognosis Prediction Of Multi-mode Magnetic Resonance Imaging In Ischemic Stroke

Objective:Ischemic stroke has the characteristics of high incidence,high mortality,high disability rate and high recurrence rate.So it is very important to judge the possibility of stroke at an early stage and prevent it at an early stage.At present,fluid-attenuated inversion recovery vascular hyperintensity(FVH)of Fluid-attenuated inversion recovery(FLAIR)sequence and the asymmetrically prominent cortical veins(APCV or PCV)of magnetic sensitive weighted imaging(SWI)sequence,and the arterial transit artifact(ATA)of pulse artery spin labeling(ASL)sequence can evaluate the collateral branches to reflect the prognosis.However,there is a lack of multimodal evaluation.We try to explore imaging value of multimodal magnetic resonance imaging in evaluating the prognosis of ischemic stroke through the above three indexes.Methods:From June 2016 to December 2017,37 patients(mean age 54 years,male 20)with ischemic stroke with anterior circulation symptomatic intracranial atherosclerotic stenosis or occlusion were enrolled in our hospital.This study has been examined and approved by the Ethics Committee of our hospital,and the patients have signed informed consent forms.All patients were examined by plain magnetic resonance imaging(MRI)and diffusion weighted imaging(DWI),ASL,SWI.The patients were followed up.The end point event was recurrent ischemic event in one year.The clinical baseline data and FVH,ATA,PCV,as well as DWI ASPECTS?ATA ASPECTS?FVH ASPECTS were compared by Chi-square test,two independent samples t test,spearman correlation analysis and receiver operating characteristic(ROC)curve.Using the occurrence of recurrent ischemic events within one year as the outcome variable,the relationship between significant variables and prognosis was determined by logistic univariate and multivariate regression analysis.Results:A total of 37 ischemic stroke patients(mean age 58+14,17 males)were included in this study.DWI positive is 19,and negative is 18.ATA positive is 30,and negative is 7.In ATA positive patients,the median ATA ASECT score was 2,with the quartile spacing1–4.The FVH positive patients were 28,and the negative patients were 7,with the median FVH ASPECTS 5 and the quartile spacing 3-6 in FVH positive patients.There were 33 PCV positive patients and 2 negative patients.After a year of follow-up,7people had ischemic events.Chi-square test showed that the occurrence of ATA was related to a good prognosis(?~2=15.518,P=0.001).There was no significant difference in DWI ASPECTS between the two independent sample t test groups(t=1.476,P=0.187).The ATA ASPECT score in the non-ischemic event group was significantly lower than that in the ischemic event group(t=6.174,P<0.001).Using logistic multivariate regression analysis and DWI ASPECTS correction,it was found that ATA ASPECTS was an independent predictor of recurrent ischemic events(OR,3.114;95%CI,1.456-6.659;P=0.003).Conclusion:ATA reflected the abundance of collateral circulation,and is closely related to recurrent stroke in ischemic stroke patients with symptomatic intracranial atherosclerotic stenosis or occlusion of anterior circulation.ATA ASPECTS score can be simple and rapid warning of the risk of recurrent stroke in such patients.