多模态MR在急性缺血性脑卒中的应用研究

目的观察多模态磁共振(MR)在急性缺血性脑卒中(AIS)的应用价值。方法选取我院58例AIS患者,均接受磁共振成像(MRI)检查[灌注加权成像(PWI)及弥散加权成像(DWI)],按照体积测定法评估灌注-弥散不匹配(perfusion-diffusion mismatch,PDM)分为阳性组与阴性组,比较2组一般资料与PDM-Alberta卒中早期CT评分(PDM-ASPECTS)情况,分析PWI-DWI融合图像ASPECTS的两名观察医师间一致性,以体积测定法PDM作为对照,评估PWI-DWI融合图像ASPECTS诊断效能。结果阳性组糖尿病、高血压、动脉硬化所占比例、PDM-ASPECTS明显高于阴性组(P<0.05);经一致性分析发现,PWI-DWI融合图像ASPECTS的两名观察医师具有较好一致性,Kappa=0.75;两名医师通过PWI/DWI融合图像ASPECTS进行PDM判定的ROC曲线下面积分别为0.886(95%CI,0.740-0.973)与0.882(95%CI,0.772-0.994),医师1诊断敏感性与特异性分别为63.72%、90.23%,医师2分别为68.25%、90.30%。结论PWI/DWI融合图像能够有效评估AIS患者PDM情况,具有较高诊断效能,为评估AIS缺血半暗带有效方式。

Application of Multi-modal MR in Acute Ischemic Stroke

Objective To observe the application value of multi-modal magnetic resonance(MR)in acute ischemic stroke(AIS).Methods A total of 58 AIS patients in the hospital were enrolled.All patients underwent magnetic resonance imaging(MRI)[perfusion weighted imaging(PWI)and diffusion weighted imaging(DWI)].The volumetry was performed to evaluate perfusion-diffusion mismatch(PDM).They were divided into positive and negative group.The general data and PDM-Alberta Stroke Program Early CT Score(PDM-ASPECTS)were compared between the two groups.The consistency of PWI-DWI fusion image ASPECTS between the two physicians was analyzed.Taking PDM of volumetry as the control,the diagnostic efficiency of PWI-DWI fusion image ASPECTS was evaluated.Results The proportions of diabetes,hypertension and arteriosclerosis,and PDM-ASPECTS in positive group were significantly higher than those in negative group(P<0.05).The consistency analysis found the consistency of PWI-DWI fusion image ASPECTS between the two physicians was good(Kappa=0.75).The areas under ROC curve of the two physicians judging PDM by PWI/DWI fusion image ASPECTS were 0.886(95%CI,0.740-0.973)and 0.882(95%CI,0.772-0.994),respectively.The diagnostic sensitivity and specificity of physician 1 were 63.72%and 90.23%,respectively,while those of physician 2 were 68.25%and 90.30%,respectively.Conclusion PWI/DWI fusion image can effectively evaluate PDM status of AIS patients,with relatively higher diagnostic efficiency,which is an effective way to evaluate ischemic penumbra of AIS.