The Predictive Value Of MR3D-ASL Combined With ABCD2 Score For Short-term Secondary Cerebral Infarction After TIA

OBJECTIVE:To analyze the predictive value of MR three-dimensional arterial spin labeling(3D-ASL)perfusion imaging technique combined with ABCD2 score for short-term secondary cerebral infarction after transient ischemic attack(TIA).METHODS:Clinical data of clinically confirmed TIA patients admitted to our hospital between June 2019 and November 2021 were collected,and conventional magnetic resonance sequence and 3D-ASL sequence scans were performed within 24 hours after onset,and patients were measured for 3D-ASL parameters relative to cerebral blood flow rCBF,ABCD2 score,measurement of serum CysC levels,and follow-up of TIA patients at The number of secondary cerebral infarcts within 7 days after the onset of the disease was measured.Patients with TIA were divided into two groups according to whether they had secondary cerebral infarction within 7 days,one group was secondary cerebral infarction group and the other group was nonsecondary cerebral infarction group.The clinical data,rCBF,ABCD2 score and serum CysC were compared between secondary cerebral infarction group and nonsecondary cerebral infarction group.The correlation between rCBF,ABCD2 score and serum CysC and secondary cerebral infarction within 7 days after the onset of TIA patients was assessed by using multifactorial logistic regression analysis.The predictive value of rCBF,ABCD2 score,serum CysC,the combination of two and three,respectively,on secondary cerebral infarction within 7 days after the onset of TIA patients was assessed by grouping rCBF,ABCD2 score and serum CysC in two groups and using subject work curves.RESULTS:The follow-up results showed that a total of 28 of the 127 TIA patients collected had secondary cerebral infarction within 7 days,accounting for approximately 22%of the cases.The results of multifactorial logistic regression analysis showed that patients’ history of hypertension,rCBF,ABCD2 score,and serum CysC were risk factors for secondary cerebral infarction within 7 days after the onset of TIA patients(P<0.05).The ABCD2 score and serum CysC of TIA patients in the secondary cerebral infarction group were(5.18±1.806),(1.03±0.135)mg/L,both higher than the ABCD2 score(2.79±1.797)and serum CysC(0.86±0.151)of patients in the group without secondary cerebral infarction;the rCBF of patients with TIA in the group with secondary cerebral infarction was(0.76±0.117),lower than that of the group without secondary cerebral infarction(0.86±0.199).All these differences were statistically significant(P<0.05).Subjects’ working curves showed that the AUC of rCBF combined with ABCD2 score to predict secondary cerebral infarction within 7 days in TIA patients was 0.922,which had the highest predictive value and was better than ABCD2 score alone,CysC alone,ABCD2 score combined with CysC,and rCBF combined with CysC.Conclusion:MR 3D-ASL combined with ABCD2 score can be better used to predict the risk of short-term secondary cerebral infarction in patients with TIA and provide a basis for clinical prognostic evaluation of patients with TIA.