Study Of Dual Phase 3D-ASL In The Treatment Of Patients With Wake-up Stroke

Objective:To explore the value of applying the dual phase post-labeling delay time(PLD)in three-dimensional arterial spin labeling technique(3D-ASL)for the hyperacute phase treatment of patients with wake up stroke(WUS).Methods:Patients with unknown onset time or new stroke symptoms after waking or during sleep were collected from October 2020 to December 2021 were examined by dual phase post-labeling delay time(PLD=1.5s,2.5s)MRI.53 patients who met the double mismatch between ASL-DWI and FLAIR-DWI were divided into intravenous thrombolysis group(n=29)and non-thrombolysis group(n=24).32 patients with routine intravenous thrombolysis in the same time window were randomly selected as the control group.The bilateral cerebral blood flow(CBF)of the patients with wake-up stroke before treatment was collected.The incidence of intracranial hemorrhage,the National Institutes of Health Stroke scale score(NIHSS)at discharge and the modified Rankin score(m RS)90 days after discharge were evaluated in the three groups.Results:There was no statistically significant difference in CBF values between all WUS patients;CBF was lower and statistically significantly different between the thrombolysis group and the non-thrombolysis group in WUS patients at PLD 1.5s and 2.5s compared with the healthy side(P<0.001),and CBF increased and statistically significantly different between the diseased side at PLD 2.5s compared with 1.5s(P<0.001);there was a statistically significant difference between the thrombolysis group and the non-thrombolysis group in WUS patients NIHSS score at discharge and 90 dm RS≤2 score after discharge were statistically different between the thrombolysis group and the non-thrombolysis group(P<0.05),and no statistical difference was seen in intracranial bleeding between the two,and no statistical difference was seen in NIHSS score,90 dm RS≤2 score and intracranial bleeding at discharge between patients in the WUS thrombolysis group and the conventional thrombolysis group.Conclusion:The prognosis of patients with wake-up stroke treated with intravenous thrombolysis after imaging evaluation is similar to that of patients treated with conventional thrombolysis.The dual phase 3D-ASL technique can play a guiding role in the hyperacute treatment of wake-up stroke patients,providing a more reliable picture of the perfusion of brain tissue.