| Objective: In this study,we combine susceptibility weighted imaging(SWI)and arterial spin labeling(ASL).By applying multiparametric magnetic resonance imaging,the purpose of this study is to investigate the clinical value of asymmetrical vein sign(AVS)and perfusion level on the prognosis of acute ischemic stroke(AIS)so as to provide an imaging basis for the detailed management and the selection of personalized treatment plans of patients with AIS.Methods:Patients diagnosed with acute ischemic stroke in the First Hospital of Hebei Medical University from October 2021 to October 2022 completed SWI and ASL within 72 hours were recruited as study subjects.After calculating the relative cerebral blood flow(r CBF),r CBF < 80%,80%-120%,and r CBF > 120%were recorded as hypoperfusion,normal perfusion,and hyperperfusion,respectively.The prognosis was assessed according to the modified Rankins Scale(m RS),defined a good prognosis for m RS scores of 0 to 2 and a poor prognosis for m RS scores of 3 to 6.Baseline clinical data,AVS and perfusion levels were compared between the two groups.The relevant signs of poor prognosis of AIS were analyzed by Logistic analysis.Analysis of the predictive value of different perfusion levels on prognosis by depicting ROC curves.Results: Thirty-six patients with AIS were divided into 20 patients in the good prognosis group and 16 patients in the poor prognosis group.Univariate analysis showed that admission NIHSS score,ACVS,AMVS,and perfusion level were statistically different on the prognosis of AIS.Among the 36 patients with AIS,there was no statistical significance between ACVS and perfusion levels,while there was statistical significance between AMVS and different perfusion levels.Multifactorial logistic analysis showed that AMVS sign(OR=18.123,95%CI: 1.138-288.608,P=0.040)and low perfusion(OR=10.869,95%CI: 1.325-89.171,P=0.026)were independent risk factors for poor prognosis of AIS.The area under the ROC curve for predicting stroke prognosis by r CBF valueswas 0.7266(P=0.0210;95%CI: 0.5270-0.9261),with an optimal threshold of 61.50%,sensitivity 95.00%,and specificity 62.50%.Conclusions:1.AMVS sign on SWI in patients with AIS without revascularization suggests poor prognosis,while ACVS does not effectively predict clinical prognosis.2.AIS patients with normal perfusion tended to have a good prognosis while those with low perfusion tended to have a poor prognosis.However,there was no significant correlation between hyperperfusion in infarct area and clinical prognosis.3.In patients with AIS,the optimal critical value of r CBF to predict poor prognosis was 61.50%,the sensitivity was 95.00%,and the specificity was62.50%. |
