Comparative Study Of Cerebral CT Perfusion Imaging And 3D Arterial Spin-labeled Cerebral Perfusion Imaging In Evaluating Blood Flow Perfusion In Acute Ischemic Cerebrovascular Disease

Objective:Analyze the relationship between magnetic resonance multi-delay three-dimensional arterial spin labeling?3D-ASL?and one-stop CTA-CTP?CT perfusion,CTP?perfusion imaging in patients with acute ischemic cerebrovascular disease.The clinical value of MR multi-delay ASL perfusion technique,especially the clinical value in the acute phase of ischemic cerebrovascular disease,was discussed.Method:Thirty-three patients who were diagnosed as acute cerebral infarction by conventional MRI and DWI in our hospital and completed multi-parameter CTP and multi-delay?post-label delay time PLD=1.5s,2.5s?3D-ASL within 24 hours were selected as the research subjects.The scanned CTP and 3D-ASL raw data were processed by the workstation to obtain the corresponding perfusion pseudo-color maps?including CTP-CBF,CBV,MTT,TTP,and dual PLD time ASL-CBF?.The region of interest?ROI?was drew using the maximum level of DWI high signal as the standard level.The area of DWI high signal area;the area of low perfusion area on 3D-ASL and CTP perfusion images;and the absolute value and relative value of perfusion parameter r?r=infarct area/healthy side mirror area?were measured and recorded.The NIHSS score scale was used to evaluate the neurological function of patients in this study on the day of admission.The above indicators were analyzed using statistical methods including consistency test?kappa?,?2 test,paired t test,and Spearman correlation analysis.The difference was statistically significant at P<0.05.Results:1.There was a difference between the ability of ASL?PLD=1.5s,2.5s?and CTP in detecting abnormal cerebral blood flow perfusion state?low perfusion and high perfusion state?,P<0.05.ASL showed a strong ability to detect high perfusion.However,there was no significant difference between the two in detecting low perfusion levels in the brain,P>0.05.2.In the cases where the ASL and CTP hypoperfusion area showed the same results,there was no statistically significant difference between ASL-CBF?PLD=1.5s?and CTP-MTT and TTP in the ability of two perfusion examination methods for showing the size of low perfusion area;and there was no significant difference between ASL-CBF?PLD=2.5s?and CTP-CBF,CBV,MTT and TTP in the ability of two perfusion examination methods for showing the size of low perfusion area,P>0.05.When evaluating the low perfusion area,PLD_1.5s.5s was not significantly different from CTP-MTT and CTP-TTP,and PLD_2.5s.5s was not significantly different from CTP-CBF?CBV?MTT?TTP.3.After excluding any cases of hyperperfusion on the perfusion image,there was a strong correlation between the relative values of ASL-CBF?PLD=1.5s,2.5s?perfusion parameters?r?and the relative values of CTP-CBF and CTP-MTT?r?,P<0.05.4.There was no obvious difference between the perfusion value of the mirror area and the infarction area in the subjects with high signal on DWI and no exact abnormal perfusion on ASL and CTP.5.There was a significant positive correlation between the area of hypoperfusion area shown by ASL cerebral blood flow chart and the area of DWI diffusion-restricted area?P<0.05?.6.The CBF value obtained by ASL scan at PLD=1.5s was significantly lower than the value obtained at PLD=2.5s,P<0.05,suggesting that ASL showed more significant hypoperfusion status at PLD=1.5s.7.The relative value of CTP-CBF perfusion parameter was negatively correlated with the NIHSS score before treatment?P<0.05?,and the relative value of CTP-MTT perfusion parameter was positively correlated with the NIHSS score before treatment?P<0.05?.Conclusion:There was no significant difference between the arterial spin labeling technology and the CTP technology in response to the reduction of intracranial blood perfusion.The arterial spin labeling technology could provide clinical hemodynamic information with good consistency with CTP in the clinic,the arterial spin labeling technology could also indicate that cerebral perfusion was abnormal and could provide valuable diagnosis and treatment information for the clinic.