Comparison of 3D-arterial spin labeling and digital subtraction angiography in the diagnosis of occlusion and collateral circulation in patients with acute ischemic stroke
10.3760/cma.j.cn431274-20220322-00217
- VernacularTitle:3D-ASL与数字减影血管造影对急性缺血性脑卒中患者闭塞部位和侧支循环的诊断价值比较
- Author:
Fuxiang SUN
1
;
Zhe ZHANG
;
Lin ZHANG
Author Information
1. 廊坊市中医医院CT/MR科，廊坊 065000
- Keywords:
Ischemic stroke;
Collateral circulation;
Arterial spin labeling;
Magnetic resonance angiography;
Angiography, digital subtraction
- From:
Journal of Chinese Physician
2023;25(1):81-85,91
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the diagnostic value of 3D-arterial spin labeling (ASL) and digital subtraction angiography (DSA) in the occlusion and collateral circulation (CC) of patients with acute ischemic stroke (AIS).Methods:From January 2019 to June 2020, 53 cases of AIS patients with middle cerebral artery (MCA) occlusion in Langfang Hospital of Traditional Chinese Medicine were selected as the research objects. All patients underwent DSA and 3D ASL examination. According to the gold standard of DSA, the diagnostic value of proximal intra-arterial signal (IAS) in 3D-ASL was observed, and the clinical value of distal IAS in the diagnosis of lateral CC was observed. Univariate and multivariate logistic regression were used to identify risk factors for poor outcome in AIS patients.Results:There were 31 cases with good collateral circulation judged by DSA. Taking DSA as the gold standard, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of digital IAS in diagnosing CC status were 93.55%, 81.82%, 87.88%, 90.00% and 88.68%, respectively. The National Institutes of Health Stroke Scale (NIHSS) score of patients with good CC assessed by 3D-ASL was lower than that of patients with poor CC at admission, and the good prognosis rate at discharge was higher than that of patients with poor CC, with statistically significant difference (all P<0.05). There was no significant difference in clinical data between patients with good CC and those with poor CC, such as gender, age, history of atrial fibrillation, hypertension, diabetes, smoking, drinking, onset to treatment time, treatment methods, etc (all P>0.05). Univariate and multivariate analysis showed that poor CC assessed by ASL was a risk factor for poor prognosis in AIS patients ( OR=5.897, P<0.05). Conclusions:The proximal and distal IAS of 3D-ASL can provide important diagnostic clues for detecting arterial occlusion and collateral perfusion in patients with AIS, and the detection of CC by ASL is of great value for prognosis.
