The Value Of Susceptibility Weighted Imaging Combined With Arterial Spin Labeling In Diagnosis And Prognosis In Mild-to-moderate Acute Ischemic Cerebral Stroke

Objective: To study the clinical evaluation value of magnetic resonance susceptibility weighted imaging combined with arterial spin labeling in ischemic penumbra,collateral compensatory reserves,hemorrhage transformation,responsible blood vessels and the recent prognosis of patients with acute cerebral infarction.Methods:From december 2014 to december 2015,35 cases diagnosed by clinical and radiological professors with acute stage(< 72h)ischemic stroke were collected in our hospital.Conventional sequences,SWI an 3d-PCASL of superconducting MRI(GE 3.0)was used.By applying post-processing software,the minimum density projection of SWI and pseudo color map of ASL were analyzed.Morphological changes of venous around the central infarction of 35 patients were analyzed,which compared to the contralateral mirror area,and divided them in group named displayed more clearly and group named displayed normally,and compared with NIHSS score of admission day and 15 days after.According to whether there was high perfusion signal around the infarct core line in ASL pseudo color map,we divided 33 cases without thrombolytic therapy into collateral compensation reserve group and the control group.And compared on the admission day with NIHSS score 15 days after.According to perfusion of infarction core in ASL,35 patients were divided into high perfusion and low perfusion group,and combined with incidence of HT were showed in SWI,relationships between different perfusion status and the happening of the HT were analyzed.Results:1、There were 27 cases with obvious display of drainage veins around the infarct area.NIHSS score of the improvement and rate of stability and progress amission day combined with 15 days after were were 48.15%(13/27),22.22%(6/27),29.63%(8/27).There were8 cases in normal group,NIHSS score of improvement rate,control rate and progression rate was75%(6/8),25%(2/8),0%(0/8).There were significant differences in the short-termprognosis in the two groups(P<0.05).There was no significant difference between the two groups in the improvement of prognosis and stable rate(P>0.05).2、There was no statistically significant difference of NIHSS score between admission day and 3 days afte of 33 cases(P > 0.05).Clinical NIHSS score of the stability factor and progress rate of the collateral compensatory group after 15 days was 76.47%(13/17),17.65%(3/17),5.88%(1/17),and were 31.25%(5/16),25%(4/16),43.75%(7/16)(P< 0.01)of 16 cases of low perfusion in the control group.The difference of NIHSS score between the two groups in the short-term prognosis was statistically significant(P<0.05).3、There were 6 cases with high perfusion in infarction core,whose incidence of HT was 100%(6/6)and 29 cases with low perfusion in infarction core,whose incidence of HT was 17.24%(5/29),in 35 cases.There was statistically significant difference between them(P < 0.01).Conclution:MRI imaging combined with ASL as well as SWI,by reflecting the acute ischemic cerebral apoplexy infarction area of blood oxygen saturation level,cell oxygen metabolic state,blood perfusion,HT and so on,the IP range,collateral compensatory reserves and short-term prognosis,infarct core perfusion status and the correlation between HT can be better evaluated and provide the basis for clinical diagnosis and treatment.