Abstract：【Objective】To investigate the differential diagnosis of ischemic penumbra (IP) in acute ischemic stroke (AIS) by susceptibility weighted imaging (SWI) and three-dimensional arterial spin labeling (3D ASL).【Methods】 Seventy-eight AIS patients admitted to our hospital from October 2016 to may 2019 were selected. Through the display of prominent cortical vein (PCV) in AIS patients by SWI and the decreased cerebral blood flow (CBF) area of AIS patients to evaluate IP, the modified alberta stroke program early CT score (ASPECTS) was used to score the IP displayed by the two methods. the results of the IP scores displayed by the two methods were compared and the clinical data of different degrees of IP were compared and analyzed.SWI showed that there was no significant difference in gender, age, onset time, diabetes mellitus, hypertension and baseline NIHSS scores between different PCV groups (P>0.05). ASL showed that there was no significant difference in gender, age, onset time, diabetes mellitus, hypertension and baseline NIHSS scores between groups in different CBF reduction areas (P>0.05). The PCV score of 78 patients was (5.06 ± 2.28) and that of CBF decreased area was (6.03 ± 2.33). The PCV score was lower than that of CBF decreased area (t=2.46,P=0.02<0.05).【Results】 There were no significant differences in clinical datum between IP groups at different degrees (P>0.05).The score of PCV for IP was lower than that of CBF reduction area, and the difference was statistically significant (t=2.46, P<0.05).【Conclusion】 The PCV sign of SWI can indirectly indicate the presence of brain IP in AIS, while the decreased CBF area displayed by 3D ASL can more directly and comprehensively show the cerebral ischemia, and 3D ASL has more advantages than SWI in displaying IP.
黄荣慧, 邓利猛, 郑兴友, 王宏伟, 张林. 3D ASL与SWI对急性缺血性脑卒中缺血半暗带的评估差异比较[J]. 医学临床研究, 2020, 37(3): 357-360.
HUANG Rong-hui, DENG Li-meng, ZHENG Xin-you, et al. Comparison of 3D ASL and SWI in Assessment of Ischemic Penumbra in Acute Ischemic Stroke. JOURNAL OF CLINICAL RESEARCH, 2020, 37(3): 357-360.
[1] Fujioka M, Okuchi K, Iwamura A,et al. A mismatch between the abnormalities in diffusion?and susceptibility?weighted magnetic resonance imaging may represent an acute ischemic penumbra with misery perfusion[J].J Stroke Cerebrovasc Dis,2013,22(8):1428-1431. [2] Verma RK, Hsieh K, Gratz PP,et al. Leptomeningeal collateralization in acute ischemic stroke: Impact on prominent cortical veins in susceptibility-weighted imaging[J].Eur J Radiol,2014,83(8):1448-1454. [3] Billiard A, Stairwell P, Levi C, et al. Arterial spin labeling identifies tissue salvage and good clinical recovery after acute ischemic stroke[J].J Neuroimaging,2013,23(3):391-396. [4] 中华神经科学会中华神经外科学会.各类脑血管疾病诊断要点[J].中华神经科杂志 , 1996,29(6):379-380. [5] 杜俊秋,董万利. SWI 与 ASL 对超急性期脑梗死缺血半暗带显示和溶栓疗效的对比研究[J].脑与神经疾病杂志,2018,26(11):704-707. [6] Park MG,Yang TI,Oh SJ,et al. Multiple hypointense vessels on susceptibility-weighted imaging in acute ischemic stroke: surrogate marker of oxygen extraction fraction in penumbra [J].Cerebrovasc Dis,2014,38(4):254-261. [7] Haacke EM,Mittal S,Wu Z,et al.Susceptibility-weighted imaging:technical aspects and clinical applications, part 1[J].AJNR Am J Neuroradiol,2009,30(1):19-30. [8] Kao HW, Tsai FY, Hasso AN. Predicting stroke evolution: comparison of susceptibility-weighted MR imaging with MR perfusion[J].Eur Radiol,2012,22(7):1397-1403. [9] Zaharchuk G. Arterial spin-labeled perfusion imaging in acute ischemic stroke[J].Stroke,2014,45(4):1202-1207. [10] Verclytte S, Fisch O, Colas L, et al. ASL and susceptibility-weighted imaging contribution to the management of acute ischaemic stroke[J].Insights Imaging,2017,8(1):91-100.
2020, Vol. 37 
