Diagnostic Value Of 3D-ASL Technology Combined With ABCD₂ Score In Transient Ischemic Attack

Objective:In this study,patients with transient ischemic attack（TIA）were performed with multi parameter three-dimensional arterial spin labeling imaging（3D-ASL）,DWI and 3D-TOF MRA,and stroke risk assessment（ABCD2 score）was performed.Objective to explore the diagnostic value of 3D-ASL technology combined with clinical ABCD₂score in TIA by analyzing the relationship between cerebral parenchymal blood perfusion and ABCD₂score and vascular stenosis,and the relationship between vascular stenosis and ABCD₂score,so as to provide more theoretical basis for clinical early diagnosis and treatment.Materials and methods:From September 2019 to December 2020,47 patients with clinically highly suspected or diagnosed TIA in the first hospital of Handan city were selected for stroke risk assessment,routine magnetic resonance imaging（T₁WI,T₂WI,T₂FLAIR）,3D-TOF MRA,3D-ASLand DWI.Based on the results of stroke risk assessment,the patients were divided into three groups:low risk,medium risk and high risk;according to the degree of MRA vascular stenosis,they were divided into four groups:No,mild,moderate and severe;combined with the cerebral blood flow（CBF）after 3D-ASL reconstruction CBF values of bilateral frontal,parietal,temporal,occipital and cerebellar hemispheres were measured to calculate r CBF.In this study,the ABCD₂score,MRA and 3D-ASL results of patients were systematically analyzed.It was concluded that 3D-ASLand MRA combined with ABCD₂score can effectively improve the diagnosis rate of TIA.Results:（1）ABCD₂score of stroke risk assessment showed that there were 25patients in low-risk group,18 patients in medium risk group and 4 patients in high-risk group;（2）Among the 10 patients with normal blood vessels,8 patients had decreased cerebral perfusion.（3）CBF values of affected side in 3D-ASL perfusion map were lower than those of mirror side,and the differences were statistically significant.r CBF values of relative cerebral blood flow were less than 0.8,showing low perfusion state.Conclusions:（1）The diagnostic accuracy of 3D-ASL was higher than that of MRA.（2）3D-ASL sequences of different PLD have differences in the detection of lesions,shorter PLD may improve the detection rate of lesions;longer PLD can reflect the compensation level of secondary collateral circulation;（3）r CBF values of different PLD in TIA patients were negatively correlated with the stenosis degree of MRA responsible vessels（rs=-0.721,P=0.018）;（4）r CBF values of different PLD are negatively correlated with ABCD₂scores at admission（within 24 hours of onset）There was a positive correlation between the stenosis degree of MRA responsible vessel and ABCD₂ score.