| [Objective]To evaluate the changes of brain function after thrombectomy in patients with anterior circulation cerebral infarction and the relationship between the changes of brain function and prognosis in patients with stroke assessed by resting-state functional magnetic resonance imaging（rs-fMRI）within 1 week after thrombectomy,and to study the prognostic indicators affecting the functional outcome of patients with anterior circulation cerebral infarction.[Methods]Patients with anterior circulation cerebral infarction who underwent RS-FMRI scan within 1 week after thrombectomy were analyzed for prognostic related clinical factors and brain function.The first part was clinical factor analysis.According to the modified Rankin Scale（mRS）90 days after discharge,cerebral infarction patients with mRS≤2 points were defined as the good prognosis group（36 cases）,and those with mRS≥3 points were defined as the poor prognosis group（25 cases）.Univariate analysis was used to compare the clinical data of the two groups,and Logistic regression was used for multivariate analysis.The second part is brain function analysis.Amplitude of low frequency fluctuation（ALFF）and regional homogeneity（ReHo）of rs-fMRI were analyzed in 33 patients with anterior circulation cerebral infarction and 18 healthy subjects.Univariate analysis was used to compare the differences in general clinical data between the two groups and to find the brain functional differences in brain regions between the two groups.According to mRS score,the enrolled patients with anterior circulation cerebral infarction were divided into two subgroups:good prognosis（16 cases）and poor prognosis（12 cases）.Another 5 patients did not complete follow-up at the time of paper submission.Spearman correlation analysis was used to explore the correlation between ALFF and ReHo values in brain regions with differences in brain function and mRS score.Univariate analysis was used to find prognostic factors by comparing ALFF and ReHo values in brain regions with differences in brain function between the two subgroups.ROC receiver operating characteristic curve（ROC）curve analysis was used to evaluate the predictive value of the influencing factors.[Results]1.The National Institutes of Health Stroke Scale（NIHSS）score 1 day after thrombectomy（score）（9.0±6.2 VS 15.6±8.0,P=0.020*）,age（years）（76.0（73.0,81.0）VS 66.0（55.5,75.5）,P=0.002*）,and times of thrombectomy（times）（2.0（1.0,3.0）VS 1.0（1.0,2.0）,P=0.01 7*）of the poor prognosis group was significantly higher than that of the good prognosis group.The male sex ratio（cases,%）（21（58.8）VS 7（28.0）,P=0.019*）and smoking（cases,%）（14（38.9）VS 3（12.0）,P=0.044*）in the good prognosis group were significantly higher than those in the poor prognosis group.Logistic regression analysis showed age（OR=1.074,95%CI:1.012-1.147,P=0.020*）,and,NIHSS score 1 day after thrombectomy（OR=1.116,95%CI:1.000～1.124,P=0.049*）were factors leading to poor prognosis after intravascular thrombectomy for patients with anterior circulation acute cerebral infarction.2.There were no significant differences in gender（P=0.525）and age（P=0.559）between stroke group and healthy control subjects.The ALFF value in the left precuneus and left and right angular gyrus of patients with anterior circulation cerebral infarction was significantly lower than that of healthy people.In addition,the ReHo values of patients with anterior circulation cerebral infarction were significantly lower in the orbital region of left middle frontal gyrus,insular lid of left inferior frontal gyrus,right angular gyrus,triangular region of left inferior frontal gyrus,and left supramarginal gyrus than in the healthy control group,and significantly higher in left and right insular brain regions than in the healthy control group.3.The ReHo value of right angular gyrus in the good prognosis group（1.21 8±0.138 VS 1.080±0.125,P=0.011*）was significantly higher than that in the poor prognosis group.The ReHo value of the right angular gyrus（r=-0.619 P=0.000**）,the ReHo value of the left supramarginal gyrus（r=-0.412 P=0.029*）,the ALFF value of the left angular gyrus（r=-0.393 P=0.03*）,and the ALFF value of the right angular gyrus（r=-0.375 P=0.049*）was negatively correlated with mRS score 3 months after thrombectomy.4.ROC curve analysis showed that area under the curve of the right angular gyrus ReHo value were 0.781,which had certain predictive value（P<0.05）.[Conclusion]1.The left precuneus,left angular gyrus,right angular gyrus,left middle frontal gyrus orbital.left inferior frontal gyrus insular lid,left inferior frontal gyrus triangle,left superior marginal gyrus,left insula and right insula may be the main areas of brain function changes after thrombectomy in patients with anterior circulation cerebral infarction.2.NIHSS score 1 day after thrombectomy and age may be predictors of poor prognosis after thrombectomy for patients with anterior circulation cerebral infarction,and ReHo value of right angular gyrus may be a predictor of good prognosis. |
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