The Research Value Of Multi-parameter 3D-ASL And SWI In The Diagnosis Of Acute Ischemic Stroke

Objective To explore the clinical value of multi-parameter 3D-ASL and SWI imaging in the diagnosis of acute ischemic stroke with acute ischemic stroke(AIS).Methods A total of 62 patients with clinically diagnosed AIS between December 2017 and December 2018 were enrolled.The interval from onset to MR check was less than 72 hours,and 9 patients with incomplete imaging and insufficient image were excluded.Finally,53 patients with acute ischemic stroke were included in the study.All patients underwent GE 3.0T(Discovery MR750)superconducting magnetic resonance imaging,including conventional plain scan sequences(T1WI,T2 WI,DWI),perfusion weighted imaging(PWI),3D-ASL and SWI.3D-ASL selects two post labeling delays(PLD),which are PLD=1.5s and PLD=2.5s respectively.Determine whether there is perfusion-diffusion mismatch(PDM),susceptibility-diffusion mismatch(SDM),arterial spin labeling-diffusion mismatch(ADM)region and statistical analysis was performed.The PDM and ADM were scored by the Alberta Stroke Program Early CT Score(ASPECTS)and statistical analysis was performed.The presence or absence of hemorrhagic transformation(HT)in the infarcted lesions was observed.SWI was compared with conventional plain scan sequences(T1WI,T2 WI,DWI)for statistical analysis.Results Of the 53 patients,24 had PDM,accounting for 45.3%,33 had ADM(PLD=1.5),accounting for 62.3%,20 had ADM(PLD=2.5),accounting for 37.7%,and24 had SDM,accounting for 45.3%.With PDM as the standard,there was no statistically significant difference in the diagnosis of PDM,ADM(PLD=1.5s),ADM(PLD=2.5s),and SDM.The PDM score was 2(1,3.8),The ADM(PLD=1.5)score is 4(2,5)and the ADM(PLD=2.5)score is 2(2,3).The difference of ADM(PLD=1.5s)score,ADM(PLD=2.5s)and PDM scores was statistically significant.Among the 53 patients,SWI detected 9 cases of HT with infarction,and 1 case was detected by conventional plain scan(T1WI,T2 WI,DWI).SWI and conventional plain scan(T1WI,T2 WI,DWI)have statistically significant difference in HT detection.Conclusions Multi-parameter 3D-ASL and SWI have diagnostic value in Ischemic penumbra(IP)and infarction-associated HT in patients with AIS,which can guide clinical treatment.