Value of perfusion-weighted imaging in predicting early neurological deterioration in mild stroke due to large vessel occlusion
10.19845/j.cnki.zfysjjbzz.2026.0028
- VernacularTitle:灌注加权成像对大血管闭塞引起的轻型脑卒中早期神经功能恶化的预测
- Author:
Yanmei GAO
1
;
Jianhua ZHAO
2
Author Information
1. Department of Neurology， People’s Hospital of Henan University， Zhengzhou 450003， China
2. Department of Neurology，Henan Provincial People’s Hospital，Zhengzhou 450003，China
- Publication Type:Journal Article
- Keywords:
Early neurological deterioration;
Magnetic resonance imaging;
Mild stroke;
Acute ischemic stroke;
Large vessel occlusion
- From:
Journal of Apoplexy and Nervous Diseases
2026;43(2):160-166
- CountryChina
- Language:Chinese
-
Abstract:
Objective Approximately 10% of patients with acute ischemic stroke （AIS） due to large vessel occlusion （LVO） present with mild stroke， and about 20% of the patients with mild stroke who do not receive reperfusion treatment will experience early neurological deterioration. This study aims to investigate the imaging indicators for predicting the onset of early neurologic deterioration （END） in patients with mild stroke due to LVO in the anterior circulation based on magnetic resonance imaging. Methods A total of 84 hospitalized patients who were diagnosed with acute anterior circulation infarction within 72 hours after disease onset in Henan Provincial People’s Hospital from January 1， 2021 to December 30， 2024 were enrolled，and 3.0 T magnetic resonance imaging was used to perform perfusion-weighted imaging （PWI） and diffusion-weighted imaging（DWI） for all patients with acute cerebral infarction. All patients had a baseline National Institutes of Health Stroke Scale（NIHSS） score of ≤5 within 24 hours after admission， and none of them received endovascular treatment. PWI and DWI imaging findings were collected from all patients to analyze regional cerebral blood flow （rCBF）， regional cerebral blood volume， mean transit time， and time to peak. The receiver operating characteristic curve was plotted to analyze the value of PWI parameters in predicting END in patients with mild stroke due to LVO in the anterior circulation who did not receive endovascular treatment. Continuous variables were stratified based on the optimal cut-off value of Youden index， and the multivariate logistic regression analysis was used to investigate the independent risk factors for END. Results The incidence rate of END was 31.0%， with the proportion of rCBF as the imaging indicator，cut-off value 29.3%. The proportion of rCBF was an independent risk factor for END （OR=14.41， 95%CI 7.00‒37.33）. Conclusion The proportion of rCBF≥29.3% has a certain value in predicting END in patients with mild stroke due to LVO in the anterior circulation and is an independent risk factor.
