Objective:Arterial spin labeling(ASL)and susceptibility weighted imaging(SWI)were used to observe the correlation between hyperperfusion in the infarct area and hemorrhagic trans-formation(HT)and the effect on 90-day prognosis in subacute ischemic stroke.Methods:Ninety-five patients with subacute ischemic stroke were included and treated with antiplatelet aggregation drugs(A drug or combined two drugs)after admission.Multiple sequence MRI(Ti WI,T2 WI,DWI,MRA,ASL,SWI)was performed within 3～7 days after symptom onset.Clinical factors were collected and e-valuated,including demographics,risk factors,stroke characteristics,etc.According to ASL,the perfu-sion status of the infarct area were divided into hyperperfusion and non-hyperperfusion.Hyperperfu-sion was defined as an increase in cerebral blood flow in the infarcted area of ≥130％on the contralat-eral side.SWI was used to assess whether HT was present in the infarct area,and HT was further di-vided into hemorrhagic infarction(HI)and parenchymal hemorrhage(PH).A good prognosis was de-fined as Modified Rankin Scale(mRS)of 0～2 at 90 days of discharge.Independent sample T test,Mann Whitney U test,x2 test or Fisher exact probability method were performed to compare the differences in clinical factors and imaging features between the HT and the non HT groups.Binary Lo-gistic regression analysis identified the independent factors affecting HT,and further explored the cor-relation between hyperperfusion in infarct area,HT and 90-day clinical outcome.Results:There were 40 cases in the HT group and 55 cases in the non-HT group.The patients in HT group had higher admis-sion NIHSS score,larger infarct volume and higher proportion of hyperperfusion in the infarct area(P＜0.05).Hyperperfusion was an independent risk factor for HT(OR=8.162,P=0.001),but 80％of HT was HI.At 90 days of discharge,there were 57 patients in the good prognosis group and 38 pa-tients in the poor prognosis group.The lower NIHSS score on admission and discharge,smaller infarct volume,and higher proportion of hyperperfusion in the infarct area were found in the good prognosis group(P＜0.05),but there was no statistically significant difference in HT between the two groups(P＞0.05).Conclusion:Hyperperfusion in the infarct area of subacute ischemic stroke is associated with a good 90-day prognosis,but it is an independent risk factor for the development of HT.Al-though most patients present HI,it is still necessary to strictly manage blood pressure to reduce the occurrence of PH.
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