Study on the Evaluation Value of Magnetic Resonance ASL Imaging in Hemorrhagic Transformation of Patients with Anterior Circulation Acute Ischemic Stroke
Objective To explore the evaluation value of magnetic resonance arterial spin labeling(ASL)imaging in hemorrhagic transformation(HT)of patients with anterior circulation acute ischemic stroke(AIS).Methods A retrospective analysis was conducted on the clinical information of 241 patients with anterior circulation AIS admitted to Bo'ai County People's Hospital from April 2023 to April 2024.The patients were divided into an HT group(n=50)and a non-HT group(n=191)based on whether they experienced HT after thrombolytic therapy.All patients underwent magnetic resonance ASL examination within 24 hours before thrombolytic therapy.General data and relative cerebral blood flow(rCBF)values at different inversion recovery times(TI)in the infarct core and core edge were compared between the two groups.Binary logistic regression analysis was used to identify independent risk factors for HT in patients with anterior circulation AIS.Results The National Institutes of Health Stroke Scale(NIHSS)scores at admission were significantly higher in the HT group than in the non-HT group(P＜0.05).The time from onset to vascular recanalization was significantly longer in the HT group than in the non-HT group(P＜0.05).The proportion of good collateral circulation was significantly lower in the HT group than in the non-HT group(P＜0.05).There were no statistically significant differences in age,gender,high-risk factors,infarct location,and responsible vessels between the two groups(P＞0.05).At different TI values,the rCBF values in the infarct core were significantly lower in the HT group than in the non-HT group(P＜0.05),while the rCBF values in the core edge were significantly higher in the HT group than in the non-HT group(P＜0.05).Binary logistic regression analysis showed that NIHSS score at admission was an independent risk factor for HT in patients with anterior circulation AIS(P＜0.05),while collateral circulation status and rCBF values were protective factors against HT(P＜0.05).Conclusion Magnetic resonance ASL imaging can objectively reflect the perfusion changes in the infarct lesion and its surrounding area in patients with anterior circulation AIS.Combined with rCBF values,it can assess the risk of HT after treatment,providing more reliable imaging evidence for improving patient prognosis.
anterior circulationacute ischemic strokemagnetic resonancearterial spin labelinghemorrhagic transformationevaluation value
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