The Clinical Value Of Artery Spin Labeling Combined With TOF-MRA And Susceptibility Weighted Imaging In Ischemic Cerebrovascular Disease

ObjectivesArtery spin labeling(ASL)perfusion imaging combined with magnetic resonance angiography(MRA)and susceptibility weighted,imaging(SWI),combined with diffusion weighted imaging(DWI)and conventional MRI comprehensive observation and analysis of the image sequence in ischemic cerebrovascular disease manifestations,investigate the clinical value of the combination of the three methods in ischemic cerebrovascular disease.Materials and methods124 patients admitted in our hospital with acute ischemic cerebrovascular disease,45-83 years old,the onset time is within 24 hours,all patients underwent CT scan to exclude cerebral hemorr-hage,and DWI,conventional MRI scan,3D-TOF MRA scan,SWI and ASL.Patients in the right position,bilateral symmetry.1.patients were divided into MRA according to MRA findings of responsible vessels positive group and negative group,according to the ASL findings of decreased perfusion and ASL perfusion in normal group two,two line McNemar test,P<0.05 had a statistically significant difference,statistical MRA positive rate and ASL responsibility vascular perfusion reduced whether rate difference has statistics significance;in accordance with DWI is divided into DWI high signal and two DWI normal group,MRA group and two of the McNemar test,the P<0.05 had a statistically significant difference,statistical MRA responsible vessels positive rate and DWI positive rate is statistically significant.2.to reduce the area of ASL perfusion as a benchmark,and DWI high signal area is divided into three groups:ASL>DWI,ASL≈DWI,ASL<DWI,and the ischemic penumbra and infarct area(ischemic,penumbra,IP)and the corresponding area of the mirror side of the CBF and ADC values were evaluated by paired sample t test experience with P<0.05,the difference was statistically significant,statistics,IP central area of infarction area and contralateral mirror regions of the CBF and ADC values are statistically significant difference.3.observe and analyze the micro hemorrhage of 124 cases of patients with SWI MinIP(Cerebral Microbleeds CMBs)brain lesion detection,signal characteristics and distribution,and Saul compared with conventional MRI sequences and CT,compare the detection rate of CMBs;at the same time to observe responsibility vessels vascular susceptibility syndrome(susceptibility vessel sign,SVS).Show,and the performance comparison with MRA,using Kappa test for consistency analysis between the two(Kappa≥0.7,the strong consistency;0.7>Kappa≥0.4,Consistency in general;Kappa<0.4,Poor consistency).Results1.124 patients,MRA blood vessel was positive in 96 cases,28 cases were negative,ASL perfusion decreased in 103 cases,21 cases of normal perfusion,the McNemar test results showed that:P=0.092,the positive rate of MRA and ASL blood vessel hypoperfusion rate had no significant difference;DWI high signal in 77 cases,47 cases of normal signal.MRA and the McNemar test results showed that:P=0.000,the positive rate was statistically significant difference,the positive rate of MRA vessels than DWI positive rate is high.2.DWI high signal in 77 cases,and ASL perfusion in the corresponding level reduced area comparisons: ASL>DW59 cases,ASL≈DWI12 cases,ASL<DWI6 cases;59 cases of patients with ASL>DWI infarction center,IP region and corresponding contralateral mirror regions CBF and ADC values of the statistical results show that the central area of infarction IP and the CBF values were statistically significant compared with the corresponding difference on the side mirror area(P=0.000),the infarct ADC values than the corresponding statistically significant differences of the mirror side(P=0.000),IP ADC was no significant difference on the corresponding side mirror area(P=0.176).3.124 patients,SWI detected 31 cases of a total of 136 CMBs,were round low signal,the boundary is clear,without peripheral edema,distributed in basal ganglia thalamus in 61,accounting for about 45% of the cortex and subcortical white matter area 47,accounting for about 34% of the brain stem 23,accounting for about 17%,the small cerebral hemisphere of 5,accounting for about 4%,CT scan and conventional MRI sequences were not detected in CMBs;94 cases were SVS positive,with responsibility of blood vessels along the strip low signal,the boundary is clear,compared to the normal blood vessel diameter,the anterior cerebral artery in 9 cases,77 cases of middle cerebral artery,8 cases of posterior cerebral artery,92 cases with MRA matched,and the two is in good agreement(Kappa=0.865);the other 2 cases of SVS located in the distal branches of the left middle cerebral artery area,while the corresponding MRA negative expression.Conclusions1.ASL and MRA blood perfusion defect responsible blood vessels were basically consistent,both from the cerebral perfusion state,cerebral vascular status of two different angles to evaluate the situation of cerebral ischemia,ischemic cerebrovascular disease especially has very important significance in the early diagnosis of TIA.2.ASL combined with DWI can detect the presence of acute cerebral infarction IP region;for TIA patients,DWI generally no abnormal performance,while ASL can detect the decrease of partial blood perfusion and improve the detection rate of TIA in time.3.SWI can detect CMBs sensitive,which is of great significance for screening and evaluation of anticoagulant and thrombolytic therapy for acute cerebral infarction;SWI and MRA were able to detect vascular responsibility of acute cerebral infarction thrombotic occlusion or stenosis,and two of them have good consistency,but in the far end of the small vascular branch thrombosis in SWI compared with MRA sensitive.4.ASL,MRA and SWI combined with DWI and conventional MRI sequences,can provide the patients with ischemic cerebrovascular disease is more comprehensive and reliable imaging information,help to improve clinical rational treatment,improve the safety of the treatment,improve the prognosis of patients.