Clinical Study On The Correlation Between FLAIR Vessel Hyperintensity And Acute Ischemic Stroke

Objective: To explore the value of flair vascular hyperintensity(FVH)in evaluating the degree of vascular stenosis,stroke severity and the location of infarction in patients with acute ischemic stroke(AIS).Methods:1.The clinical and imaging data of AIS patients in the middle cerebral artery(MCA)territory who were admitted to the third hospital of hebei medical university from January 2017 to June 2019 were collected.2.According to the distribution characteristics in the MCA territory on DWI,the infarcts were divided into perforating artery type,watershed type,regional type and mixed type.3.The method of dividing the MCA cortex using the ASPECTS(Alberta stroke program early CT score)was used to calculate the FVH of each cortical region in MCA.Patients were divided into two groups based on the FVH-ASPECT score,with 0-3 points being the FVH low-score group and 4-7 points being the FVH high-score group.4.To compare the demographic information,the location and degree of vascular stenosis,NIHSS and the Infarction location between the two groups.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of FVH-ASPECT score on vascular occlusion.Results: 1.FLAIR images were read in 214 patients with AIS in the middle cerebral artery territory,including 51 in FVH high-score group and 163 in FVH low-score group.2.The admission NIHSS score(Z=-2.131,P=0.033)of the FVH high-score group was higher than the FVH low-score group.3.The proportion of watershed infarction(χ~2=9.979,P=0.002)and intracranial carotid artery lesions(χ~2=6.411,P=0.011)in FVH high-score group were higher than that in FVH low-score group,while the proportion of perforating artery infarction was lower than that in FVH low-score group.4.There were significant differences in the proportion of normal,mild and occluded vessels between the two groups(χ~2=8.832,P=0.003;χ~2=8.888,P=0.003;χ~2=50.528,P=0.000).Spearman analysis showed that FVH-ASPECT score was positively correlated with the degree of the ipsilateral internal carotid artery or middle cerebral artery stenosis(r=0.468,P=0.000).ROC curve analysis indicated that the optimal cutoff value of FVH-ASPECTS for the diagnosis of vascular occlusion was 3 points.Compared with MRA,its sensitivity was 74.4% and specificity was 80.1%.Conclusions: For patients with AIS in middle cerebral artery territory,the FVH-ASPECT score is positively related to the degree of intracranial arterial stenosis,which can also reflect the severity of stroke and the Infarction location.