| 【Objective】The arterial spin labeling(ASL)was used to evaluate the perfusion status and clinical significance around the infarction core in patients with acute cerebral infarction,and the magnetic sensitivity weighted imaging(SWI)was used to explore the clinical significance of the abnormal display of the small vein around the infarction core in patients with acute cerebral infarction.ASL and SWI were used to evaluate the relationship between local circulation and prognosis.【Materials and methods】54 patients with acute cerebral infarction confirmed by clinical diagnosis and imaging examination were included in this experimental study.All the subjects included in the study were examined by Siemens 3.0T superconducting magnetic resonance imaging system with conventional sequence,magnetic sensitivity weighted imaging(SWI)and arterial spin labeling(ASL).The fluctuation range of the threshold value is 20%.The image is processed by software and rCBF value is compared.According to this,the abnormal high signal area of DWI and its surrounding perfusion state are divided into three groups: high perfusion(rCBF ratio between the patient side and the healthy side is more than 120%),no change(rCBF ratio between the patient side and the healthy side is between 80%-120%),and low perfusion(rCBF ratio between the patient side and the healthy side is less than 80%).In patients with acute cerebral infarction,PLH(peripheral hyperperfusion)occurs around the abnormal high signal area of DWI.The presence of PLH can be judged by ASL images,and the subjects in the study group and the control group can be included.The correlation of PLH with NIHSS score and prognosis on the day of admission was evaluated by means of "mean ± standard deviation((?) ±s)",t-test and Spearman correlation analysis.For the display of peripheral blood vessels in acute cerebral infarction,SWI MIP was used to grade them(0,1,2),and "mean ± standard deviation((?) ±s)",t-test and Spearman correlation analysis were used to evaluate the correlation between the grading of peripheral vein abnormalities in acute cerebral infarction and NIHSS score and prognosis on the day of admission.The correlation between ASL and SWI images was analyzed comprehensively.Spearman correlation analysis was used to evaluate the correlation between the perfusion status around the infarction core and the venous abnormality,the correlation between the ischemic penumbra(IP)and the venous abnormality,and the correlation between the perfusion status of the acute infarction core and the hemorrhagic transformation(HT).【Results】1.54 patients showed high signal on DWI image and low signal on ADC.2.There were 37 cases of abnormal perfusion in the high signal area of DWI,including 21 cases of hyperperfusion and 16 cases of hypoperfusion,so the number of cases in the PLH group was 21(21/54,38.9%)and the number of cases in the control group was 33.Comparing the PLH group with the control group,it was found that there was a statistically significant difference between PLH and the NIHSS score on the day of admission and the prognosis of the patients(P <0.05).3.Among the 54 patients,31 patients had more and coarser focus area than the contralateral,in which the number of cases of peripheral vein increased significantly and coarsened was 12;the number of cases of mild increased and coarsened was 19.There was no significant difference between the grade of venous abnormality around the acute cerebral infarction and the NIHSS score on the day of admission(P > 0.05),but there was significant difference with the prognosis of the patients(P < 0.05).4.Eighteen of the 21 patients in the PLH group showed no abnormalities in the veins in the infarcted area,and the remaining three patients had grade 1 changes in venous abnormalities.Thirteen of the 54 patients included in the group showed the presence of an ischemic penumbra(IP),and 10 of them had grade 2 changes in venous abnormalities.The distribution range of venous abnormalities is close to the abnormal hypoperfusion area around the core of the lesion shown by ASL.The difference between the perfusion status around the infarcted core and the grade of SWI venous abnormalities was statistically significant(P <0.05).There was a statistically significant difference in IP and SWI venous abnormality classification(P <0.05).【Conclusion】1.ASL images indicate the high perfusion status of the core and surrounding areas of acute infarction.PLH indicates that the prognosis of patients is relatively good.2.SWI images showed the abnormal distribution of the core and peripheral vein of acute infarction.The abnormal increase and thickening of the vein in the focus area indicated the greater degree of nerve damage and the poor prognosis of the patients.3.ASL combined with SWI can prompt the hemodynamic information around the focus of patients,and also indicate whether IP exists and the risk of HT,which is more helpful to evaluate the patients’ condition,guide the clinical development of a more suitable treatment plan for patients,and improve the effectiveness of treatment. |
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