Value of MRI-DWI on Evaluating Ischemic Penumbra of Cerebral Infarction and Predicting Recurrence
Objective To analyze the value of magnetic resonance imaging-diffusion weighted imaging(MRI-DWI)on evaluating ischemic penumbra of cerebral infarction and predicting the recurrence.Methods Clinical data of 62 patients with acute cerebral infarction admitted to our hospital from January 2020 to June 2022 were collected.All patients underwent MRI examination after admission and received intravenous thrombolytic therapy.The patients were divided into DWI-FLAIR matching group and DWI-FLAIR non-matching group according to the consistency of DWI and fluid-attenuated inversion-recovery sequence(FLAIR)signal at admission.Baseline data such as underlying disease and apparent diffusion coefficient(ADC)of infarction lesion and clinical outcomes were compared between the two groups.All patients were followed up for 1 year to observe the 1-year recurrence rate.Results The lesion volume and National Institutes of Health Stroke Scale(NIHSS)score before thrombolysis in DWI-FLAIR non-matching group were significantly less or lower than those in DWI-FLAIR matching group(P＜0.05)while the ADC value was significantly higher than that in DWI-FLAIR matching group(P＜0.05).NIHSS score in DWI-FLAIR non-matching group was significantly lower than that in DWI-FLAIR matching group at 1 day and 7 days after thrombolysis(P＜0.05)while the good prognosis rate after 30 days of thrombolysis was higher than that in DWI-FLAIR matching group(P＜0.05).The 1-year recurrence rate was significantly lower in DWI-FLAIR non-matching group than that in DWI-FLAIR matching group(3.57％vs 26.47％,P＜0.05).ADC value of patients with 1-year recurrence at initial admission was(0.29±0.04)×10-3mm2/s,which was significantly lower than(0.40±0.08)×10-3mm2/s of patients with 1-year non-recurrence at admission(P＜0.05).ROC curve also showed that the ADC value at admission was statistically significant in predicting 1-year recurrence(P＜0.05),and the cutoff value was 0.33×10-3mm2/s.Conclusion DWI-FLAIR non-matching suggests ischemic penumbra,good prognosis of intravenous thrombolysis and lower risk of recurrence in patients with acute cerebral infarction,and ADC value in infarction lesion area is also beneficial to predicting the 1-year recurrence risk.
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