Predictive value of susceptibility weighted imaging and arterial spin labeling imaging for cerebral hemorrhage transformation after thrombolysis in stroke
Objective To analyze the clinical value of susceptibility weighted imaging(SWI)and arterial spin labeling imaging(ASL)in the prediction of hemorrhage transformation after thrombolysis in acute ischemic stroke.Methods A total of 80 patients with acute ischemic stroke admitted to Guangdong Tongjiang Hospital from December 2021 to November 2023,before and within 24 h after thrombolytic therapy,were enrolled,and all of them underwent computed tomography(CT),magnetic resonance imaging(MRI),SWI and ASL sequential scanning.The brush sign and asymmetrical cortical venous sign of patients were analyzed,and the diagnostic value of SWI and ASL for cerebral hemorrhage transformation after thrombolysis was compared.Eleven patients with cerebral hemorrhage transformation after thrombolysis were included in hemorrhagic transformation group,while the other 69 patients without hemorrhagic transformation were included in non-hemorrhagic transformation group.Logistic regression analysis was conducted to explore the influencing factors of hemorrhagic transformation after thrombolysis.Results The positive rates of brush sign and asymmetric cortical vein sign were 71.25%(57/80)and 68.75%(55/80)by SWI scanning before thrombolysis in 80 patients with acute ischemic stroke,while those were 16.25%(13/80)and 15.00%(12/80)after thrombolysis.The differences between brush sign and asymmetric cortical venous sign detected by SWI before and after thrombolysis were statistically significant(P<0.05).SWIversus ASL had sensitivity of 90.91%(10/11)versus72.73%(8/11),specificity of 95.65%(66/69)versus88.41%(61/69),and accuracy of 95.00%(76/80)versus86.25%(69/80)in the diagnosis of cerebral hemorrhage transformation after thrombolysis,revealing that SWI had higher sensitivity and specificity than ASL.The univariate analysis of cerebral hemorrhage transformation showed that the age,atrial fibrillation,NIHSS score and CMBs grade in two groups differed significantly(P<0.05);and the multivariate analysis identified atrial fibrillation,NISHH score and CMBs grade as independent risk factors of cerebral hemorrhagic transformation after thrombolysis.Conclusion SWI has high sensitivity in detecting brush sign and asymmetric cortical venous sign,which is of great value for predicting cerebral hemorrhage transformation after acute thrombolysis,and can be used as a routine examination sequence for acute ischemic stroke.
万方数据
维普
