关键词:

弥散加权成像, 磁共振, C反应蛋白, 急性缺血性脑梗死

Abstract:

Objective　To evaluate the value of diffusion-weighted magnetic resonance imaging (DWI) combined with serum C-reactive protein (CRP) in identifying the time window of acute ischemic cerebral infarction. Methods　A retrospective analysis was conducted on the clinical data of 195 patients with acute cerebral infarction admitted to Baoji Central Hospital from June 2021 to June 2023. There were 111 males and 84 females; they were 57-75 years old. The patients were divided into an ultra-acute stage group (course of disease ≤ 6 h; 67 cases), an acute stage group (course of disease of 6-72 h; 79 cases), and a subacute stage group (course of disease of ≥72~168 h; 49 cases) according to the time from onset to magnetic resonance imaging examination. The DWI examination results [apparent diffusion coefficient (ADC)] and CRP levels of the three groups were compared. The value of DWI combined with CRP in identifying the time window of acute cerebral infarction was analyzed using the receiver operating characteristic curve (ROC). t and F tests were applied. Results　The ADC of the affected side in the ultra-acute stage group [(0.33±0.08)×10^-3 mm²/s] was significantly lower than those in the acute stage group [(0.40±0.09)×10^-3 mm²/s] and the subacute stage group [(1.56±0.25)×10^-3 mm²/s], with a statistical difference between the 3 groups (F=34.455, P<0.05). In the ultra-acute stage group and the acute stage group, the ADC values of the affected sides were significantly lower than those of the healthy sides (both P<0.05). In the subacute stage group, the ADC value of the affected side was significantly higher than that of the healthy side (P<0.05). The CRP level in the ultra-acute stage group [(9.39±3.03) mg/L] was significantly higher than those in the acute stage group [(6.01±1.27) mg/L] and the subacute stage group [(5.48±1.33) mg/L] (q=16.09 and 712.295; both P<0.05); there was no statistical difference in CRP level between the acute stage group and the subacute stage group (q=1.933; P>0.05). The ROC showed that the area under the curve (AUC), sensitivity, and specificity of ADC value for distinguishing acute ischemic cerebral infarction from ultra-acute phase were 0.587, 100.00%, and 38.38%. The AUC, sensitivity, and specificity of CRP were 0.888, 73.13%, and 96.87%. The AUC, sensitivity, and specificity of ADC value combined with CRP were 0.918, 85.07%, and 86.72%. Conclusions　Both ADC value and serum CRP level in patients with acute ischemic cerebral infarction can be used to identify the time window. ADC has high sensitivity while CRP has high specificity for identifying ultra-acute ischemic cerebral infarction. Combination of the two can optimize the differentiation efficiency.

Key words:

Diffusion-weighted imaging, Magnetic resonance, C-reactive protein, Acute ischemic cerebral infarction