| Objective:To explore the application of magnetic sensitive imaging in acute cerebral infarction with large artery occlusion.Methods: To collect 48 cases of acute arterial occlusion of cerebral infarction patients' imaging and clinical data in the Wan Nan Medical College Yijishan Hospital from January 2016 to December 2017,28 cases of which were male,20 were female,age from 38 to 84,the average age(64.2 + 11.5).The onset time is from 1 to 11 days,the average days(4.2 + 1.6).Among them,20 patients 3 days after the onset of the disease,21 in middle cerebral artery occlusion,14 in internal carotid artery occlusion,5 in anterior cerebral artery occlusion,8 in posterior cerebral artery occlusion.All patients underwent cranial CT scan and multi parameter MRI(T1WI,T2 WI,FLAIR,DWI,3D TOF MRA,SWI).Reader A and Reader B read the film independently and recorded the informations.Firstly,the upper cerebral hemisphere of the lateral tentorium was divided into 15 independent cerebral blood supply regions according to aspects score criteria.The DWI and SWI images of 20 patients(300 cerebral blood supply regions)with acute cerebral infarction within 3 days after onset were examined,analyzed and recorded without mutual interference.Kappa analysis was used to analyze the consistency of cerebral blood supply regions involved in the asymmetry of SWI veins judged by Reader A and Reader B,and Kappa analysis was used to judge the consistency of cerebral blood supply regions involved in DWI high signal.The results of SWI-DWI mismatch area evaluated by both Reader A and Reader B were tested by c2.The differences of detection and classification of HT in all 48 patients were compared with SWI,CT plain scan and MR routine sequence by c2 and Fisher test.The SVS and HMCAs positive for middle cerebral artery thrombosis detection difference was analyzed by Fisher in 35 cases of patients with acute cerebral infarction with middle cerebral artery and internal carotid artery occlusion in.The consistency of SVS and HMC as positive in the middle cerebral artery thrombosis detection was analyzed by Kappa.Results: 1.The consistency of the cerebral blood supply area in SWI images of acute cerebral infarction within 3 days after onset was very high,kappa =0.912,(95% CI,0.865-0.959);The consistency of DWI high signal of acute cerebral infarction within 3 days after onset was very high in the cerebral blood supply area,kappa =0.963,(95% CI,0.931-0.995).2.Among 300 cerebral blood supply areas within 3 days after the onset of the disease,26 were found to be not matched by SWI-DWI,P=0.0357,P<0.05.The difference was statistically significant.The SWI-DWI did not match the cerebral blood supply area of 28,P=0.0191,P<0.05,the difference was statistically significant.3.SWI,CT plain scan and MRI routine sequence were different in detecting HT,c2 =11.476,P=0.0032;There were differences in SWI and CT plain scan during HT detection,c2 =9.895,P=0.0017;The difference of conventional sequence between SWI and MR in HT detection was c2 =6.171,P=0.0123.The above P values were less than 0.05,The difference was statistically significant.4.The results of plain scan of SWI and CT in HT were examined by c2 and Fisher.HI1 type c2=4.376,P=0.0365,P<0.05,the differences are statistically significant;HI2 type P=0.2936,PH1 type P=0.2389,PH2 type P=0.5575,there were no statistical significance difference among HI2 type?PH1 type?PH2 type.The results of detection of SWI and MR conventional sequences in HT were analyzed by c2.HI1 type c2=2.274,P=0.1316,HI2 type P=0.5038,PH1 type P=0.2389,PH2 type P=0.5575,The above P values were more than 0.05,The difference was no statistically significant.5.There was no significant difference between SVS and HMCAs positive to found in the positive diagnosis of middle cerebral artery thrombosis(MCA)by Fisher,P=0.4543,P?0.05.6.SVS and HMCAS positive were moderate and highly consistent in the diagnosis of middle cerebral artery thrombosis,Kappa=0.5679,(95% CI,0.289-0.847).Conclusion:1.The consistency of SWI venous images and DWI images in acute cerebral infarction is very high,and the application of both can predict the existence of ischemic half-dark zone.2.SWI-DWI mismatch zone is a simple,fast and non-invasive imaging method for predicting ischemic semi synthesis.It is highly repeatable and can be used for clinical screening and arterial thrombolysis.3.SWI can be used to detect HT,SWI is more sensitive to detect HT than CT scan and MR routine sequence.Compared with CT plain scan,SWI can detect more HI1 type HT.4.SWI can be used not only for detecting cerebral middle artery thrombosis,but also for morphological analysis of cerebral middle artery thrombosis and predicting the composition of thrombus,It could be used to guide the clinical thrombolytic therapy.5.SWI has great application value in acute cerebral infarction.The imaging method is fast,easy to process,informative and has a wide application prospect.It should be used routinely in acute cerebral infarction... |
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