| 摘要: |
| ［摘要］ 目的 探讨基于磁共振（MR）动态磁敏感对比灌注成像（DSC-PWI）原始图的侧支循环分级在急性前循环大血管闭塞性脑梗死患者中的应用价值。方法 回顾性分析2020年1月至2024年4月梧州市工人医院收治的114例单侧前循环大血管闭塞所致的大脑中动脉供血区急性脑梗死患者的临床资料。患者均经头部磁共振血管造影（MRA）确诊，其中76例接受数字减影血管造影（DSA）检查。分析2名评估者所得侧支循环分级结果的一致性，分析DSC-PWI原始图与DSA评估侧支循环分级结果的一致性。比较基于DSC-PWI原始图评估的侧支循环情况与低灌注区体积、核心梗死区体积及低灌注区与核心梗死区不匹配区域比值（mismatch比值）的关联性。结果 2名评估者基于DSC-PWI原始图评估侧支循环分级结果的一致性较好（Kappa=0.821，P<0.001）。基于DSC-PWI原始图与DSA评估侧支循环分级结果的一致性较好（Kappa=0.801，P<0.001）。侧支循环良好组的低灌注区体积、核心梗死区体积均小于侧支循环不良组，mismatch比值大于侧支循环不良组，差异有统计学意义（P<0.05）。Spearman秩相关分析结果显示，DSC-PWI原始图的侧支循环分级与核心梗死区体积（rs=-0.613，P<0.001）、低灌注区体积（rs=-0.382，P<0.001）呈负相关，与mismatch比值（rs=0.320，P<0.001）呈正相关。结论 基于DSC-PWI原始图可以用于评估急性前循环大血管闭塞性脑梗死的侧支循环情况。 |
| 关键词: 磁共振 动态磁敏感对比灌注成像 脑梗死 侧支循环 |
| DOI：10.3969/j.issn.1674-3806.2025.08.15 |
| 分类号: |
| 基金项目:广西卫生健康委科研项目（编号：Z20211371） |
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| Application value of collateral circulation grading based on magnetic resonance DSC-PWI raw images in patients with acute anterior circulation large vessel occlusive cerebral infarction |
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YAN Da1, XIE Jinlan1, CHE Jinlian2, MENG Yinying1, CHEN Weihua1
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1.Department of Radiology, Wuzhou Gongren Hospital, Wuzhou 543001, China; 2.Department of Radiology, Maternity and Child Healthcare Hospital of Guangxi Zhuang Autonomous Region, Nanning 530000, China
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| Abstract: |
| ［Abstract］ Objective To explore the application value of collateral circulation grading based on magnetic resonance dynamic susceptibility contrast-enhanced perfusion-weighted imaging(DSC-PWI) raw images in patients with acute anterior circulation large vessel occlusive cerebral infarction. Methods The clinical data of 114 patients with acute cerebral infarction in the supplying area of the middle cerebral artery caused by unilateral anterior circulation large vessel occlusion who were admitted to Wuzhou Gongren Hospital from January 2020 to April 2024 were retrospectively analyzed. All the patients were diagnosed through head magnetic resonance angiography(MRA), among whom 76 patients received digital subtraction angiography(DSA) examination. The consistency of the results of collateral circulation grading obtained by two evaluators was analyzed. The consistency of the results of collateral circulation grading assessed by using DSC-PWI raw images and DSA was analyzed. The correlation between collateral circulation assessed by using DSC-PWI raw images with the perfusion deficit volume, infarct core volume, and ratio of the mismatch area between the perfusion deficit volume and the infarct core volume(mismatch ratio) was compared. Results There was good consistency in the assessment of collateral circulation grading results based on DSC-PWI raw images by 2 assessors(Kappa=0.821, P<0.001). There was good consistency in the assessment of collateral circulation grading results based on DSC-PWI raw images and DSA(Kappa=0.801, P<0.001). The perfusion deficit volume and infarct core volume in the good collateral circulation group were smaller than those in the poor collateral circulation group, and the mismatch ratio in the good collateral circulation group was greater than that in the poor collateral circulation group, with statistically significant differences between the two groups(P<0.05). The results of Spearman rank correlation analysis showed that collateral circulation grading based on DSC-PWI raw images was negatively correlated with the infarct core volume(rs=-0.613, P<0.001), perfusion deficit volume(rs=-0.382, P<0.001), and was positively correlated with the mismatch ratio(rs=0.320, P<0.001). Conclusion DSC-PWI raw images can be used to assess the collateral circulation of acute anterior circulation large vessel occlusive cerebral infarction. |
| Key words: Magnetic resonance Dynamic susceptibility contrast-enhanced perfusion-weighted imaging(DSC-PWI) Cerebral infarction Collateral circulation |
