颈动脉彩超联合颅脑MRI可评估前循环动脉粥样硬化性脑梗死患者的病情

  目的  探究前循环动脉粥样硬化性脑梗死患者采用颈动脉彩超联合颅脑MRI评估病情严重程度临床价值。  方法  回顾性分析2021年1月~2021年11月医院收治50例前循环动脉粥样硬化性脑梗死患者的资料，依据美国国立卫生研究院脑卒中量表评分，将患者分别纳入轻型脑梗死组（≤7分，n=40）与重型脑梗死组（> 7分，n=10）。患者均接受颈动脉彩超及颅脑MRI检查，分析两者联合在患者病情严重程度上评估价值。  结果  重型脑梗死组患者不稳定斑块比例、狭窄率、搏动指数（PI）、阻力指数（RI）均高于轻型脑梗死组患者，峰值流速（PSV）、舒张末期流速（EDV）低于轻型脑梗死组患者（P < 0.05）；重型脑梗死组患者表面弥散系数（ADC）低于轻型脑梗死组患者（P < 0.05），两组患者T1WI信号与T2WI信号检出情况的差异无统计学意义（P > 0.05）；Spearman相关性分析显示，ADC、不稳定斑块、PI、RI、PSV、EDV与患者病情严重程度存在相关性（P < 0.05）；ROC曲线显示ADC、不稳定斑块、PI、PSV、RI、EDV用于重型脑梗死评估曲线下面积分别为0.638、0.556、0.600、0.608、0.798、0.713，各指标联合曲线下面积值为0.968。  结论  前循环动脉粥样硬化性脑梗死患者病情可以采用颈动脉彩超与颅脑MRI进行评估，两者用于患者病情严重程度评估均有一定价值。  

Application of carotid artery color Doppler ultrasound combined with brain MRI in patients with anterior circulation atherosclerotic cerebral infarction

  Objective  To investigate the clinical value of carotid artery color Doppler ultrasound combined with brain MRI in severity evaluation of anterior circulation atherosclerotic cerebral infarction.  Methods  A retrospective review was conducted on the data of 50 patients with anterior circulation atherosclerotic cerebral infarction who were admitted to the hospital between January and November. The patients were divided into the mild cerebral infarction group (n=40, NIHSS score ≤7) and the severe cerebral infarction group (n=10, NIHSS score > 7) according to the NIHSS score. All patients were examined with carotid artery color Doppler ultrasound and brain MRI. The value of combination of the two methods in severity evaluation was analyzed.  Results  The proportion of unstable plaques, stenosis rate, pulsatility index (PI) and resistance index (RI) in the severe cerebral infarction group were higher than those in the mild cerebral infarction group. The peak systolic velocity (PSV) and end-diastolic velocity (EDV) were lower than those in the mild cerebral infarction group (P < 0.05). The apparent diffusion coefficient (ADC) of the severe cerebral infarction group was significantly lower than that of the mild cerebral infarction group (P < 0.05). The detection of T1WI signals and T2WI signals showed no statistically significant difference between the groups (P > 0.05). Spearman correlation analysis found that ADC, unstable plaque, PI, RI, PSV, and EDV were correlated with the severity (P < 0.05). ROC curve analysis found that the AUC values of ADC, unstable plaque, PI, PSV, RI, and EDV to evaluate severe cerebral infarction were 0.638, 0.556, 0.600, 0.608, 0.798 and 0.713, respectively. The AUC of joint evaluation with these indicators was 0.968.  Conclusion  Carotid artery color Doppler ultrasound and brain MRI both can be used for severity evaluation of patients with anterior circulation atherosclerotic cerebral infarction.