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• Clinical Article •
The value of susceptibility weighted imaging combined with arterial spin labeling in diagnosis and prognosis in mild-to-moderate acute ischemic cerebral stroke
ZHOU Jian-guo  FU Da-yong  LI Yong-gang 

DOI:10.12015/issn.1674-8034.2016.09.005.


[Abstract] Objective: To study the clinical diagnostic value of 3.0 T magnetic resonance susceptibility weighted imaging (SWI) combined with arterial spin labeling (ASL) in ischemic penumbra (IP), collateral compensatory reserves, hemorrhage transformation (HT), responsible blood vessels and the recent prognosis of patients with acute cerebral infarction.Materials and Methods: Thirty-five patients with acute ischemic stroke underwent conventional MR sequences, SWI and 3D-PCASL check. Then the SWI minimum intensity projection and 3D-ASL pseudo color pictures were obtained by postprocessing with the software. According to drainage morphological changes around infarction core, 35 cases were divided into the obvious display group and the normal display group. Respectively, the NIHSS score of the two groups on the day of admission and the 15th day was analysed. Thirty-three patients without thrombolytic therapy, according if creeping line strip high perfusion signal existed in the 3D-ASL pseudo color pictures that surrounding the infarction core area, were divided into the collateral compensative group and the control group, and on the day of admission and after 15 d NIHSS scores were analyzed respectively on the day of admission and the 15th day. According to the difference of perfusion state in the infarct core area 3D-ASL suggested, 35 cases were divided into high perfusion group and low perfusion group. Combined with the incidence of HT SWI, the relationship between different perfusion status in the core area of infarction and the occurrence of HT was statistically analysed.Results: The obvious display group showed the prognosis, stability and progress in proportion respectively for 13/27, 6/27 and 8/27, while the normal display group showed that respectively for 6/8, 8 and 0/8, the progress difference of short-term prognosis of two groups was statistically significant (P=0.0432). The NIHSS score difference between the collateral compensative group and the control group was not statistically significant (t=0.886, P=0.392). The collateral compensative group showed the recent prognosis improvement, stability and progress in proportion respectively for 13/17, 3/17 and 1/17, while the control group showed that respectively for 5/16, 4/16 and 7/16, and between the two groups after 15 d NIHSS score differences had statistical significance (t=2.296, P=0.039). The incidence of HT in the infarction core high perfusion group was 6/6, while the proportion of HT in the low perfusion group was 5/29, and the difference between the two groups was statistically significant (P=0.000).Conclusions: MRI imaging combined with ASL as well as SWI, can better evaluate cell oxygen metabolic state, blood perfusion, HT and so on, the IP range, collateral compensatory reserves and short-term prognosis, which provide the basis for clinical diagnosis and treatment.
[Keywords] Ischemic stroke；Aterial spin labeling；Susceptibility weighted imaging；Collateral circulation

ZHOU Jian-guo Nanjing University of Chinese Medicine Affiliated Lianyungang Hospital and Lianyungang Hospital of Traditional Chinese Medicine, Lianyun-gang 222004, China; Department of Medical Imaging, the First Pople's Hospital of Suzhou University, Suzhou 215006, China

FU Da-yong Nanjing University of Chinese Medicine Affiliated Lianyungang Hospital and Lianyungang Hospital of Traditional Chinese Medicine, Lianyun-gang 222004, China

LI Yong-gang* Department of Medical Imaging, the First Pople's Hospital of Suzhou University, Suzhou 215006, China

*Correspondence to: Li YG, E-mail: liyonggang224@163.com

Conflicts of interest   None.

Received  2016-07-05
Accepted  2016-08-16
DOI: 10.12015/issn.1674-8034.2016.09.005
DOI:10.12015/issn.1674-8034.2016.09.005.

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