Evaluation for Prognosis of Progressive Cerebral Infarction Using Multi-phase Delay PCASL
Objective To evaluate the prognosis of progressive cerebral infarction(PIS)through using multi-phasic post labeling delay(PLD)pseudo-continuous arterial spin labeling technique(PCASL)combined with diffusion-weighted imaging(DWI).Methods A total of 55 patients with acute cerebral infarction diagnosed by clinical and DWI were prospectively included in DWI and multi-phase delayed PCASL examination.The high signal area of DWI and the CBF value of blood perfusion in the infarcted area were calculated.The patients were divided into progressive cerebral infarction group and non-progressive cerebral infarction group.The differences of parameters in different groups were compared,Receiver Operating Characteristic(ROC)curve was drawn,and the diagnostic efficiency and prognostic value of each parameter were evaluated.Results Of the 55 patients with acute cerebral infarction,20 were PIS,35 were non-PIS.The values of CBF were statistically significant in PIS group and non-PIS group(P＜0.05).The CBF value of 1.5s-PLD was(14.82±5.15)ml/100mg/min in PIS group and(28.42±11.64)mL/100mg/min in non-PIS group;The CBF value of 2.0s-PLD was(23.96±9.51)mL/100mg/min in PIS group and(33.79±13.52)mL/100mg/min in non-PIS group.The CBF value of 2.5s-PLD was(30.51±11.22)mL/100mg/min in PIS group and(38.67±12.86)mL/100mg/min in non-PIS group.The infarct size of DWI was(886.24±12.32)mm2 in PIS group and(900.76±1087.21)mm2 in non-PIS group respectively,and there was no significant difference between the two groups(P＞0.05).ROC curve analysis indicated that the 1.5s-PLD CBF value was most effective in the diagnosis of PIS.The largest area under curve(AUC)was 0.89 at a CBF value of 19.29 mL/100mg/min,and the sensitivity and the specificity were 80％and 85％,respectively.Conclusion The multiphasic PLD method demonstrates high accuracy in predicting progressive cerebral infarction(PIS).When the PLD is set to 1.5 seconds,the derived cerebral blood flow(CBF)value of 19.29 mL/100mg/min exhibits superior sensitivity and specificity compared to other perfusion parameters.Therefore,it can serve as a reliable indicator for identifying PIS.
万方数据
维普
