Abstract:

Objective　To explore the clinical significance of magnetic resonance fluid attenuation inversion recovery (FLAIR) sequence vascular high signal intensity (FVH) and prognosis. Methods　A total of 100 patients with acute ischemic stroke (onset time<72 hours) admitted to the outpatient and emergency departments of The First People's Hospital of Guannan County and Lianyungang Hospital, Nanjing University of Chinese Medicine from January 2020 to December 2022 were selected. Based on the presence or absence of FVH signs, they were divided into an FVH positive group and an FVH negative group. There were 40 patients in the FVH negative group, including 22 males and 18 females, with an age of (65.49±12.13) years. There were 60 patients in the FVH positive group, including 33 males and 27 females, with an age of (66.32±15.21) years. At admission and on the 15th day after admission, the National Institutes of Health Stroke Rating Scale (NIHSS) and the 3-month Post Stroke Modified Rankin Scale (MRS) were used to determine the degree of neurological impairment. The infarct sizes of the two groups were compared. The distribution of FVH sign positivity was further matched with the DWI core infarct area, and the patients were divided into a matched group and an unmatched group; the MRS scores of the two groups were compared 3 months after discharge. The t, rank sum, and χ² tests were applied. Results　There were statistical differences in the scores of NIHSS on the day 1 of 15 admission and MRS score 3 months after discharge between the FVH positive group and the FVH negative group [(9.49±1.32) vs. (10.26±1.21), (7.82±1.45) vs. (9.54±1.32), and (3.48±1.22) vs. (4.81±1.32); all P<0.05]. The proportion of large infarcts in the FVH negative group was 55% (22/40), while that in the FVH positive group was 18.33% (11/60); there was a statistical difference in the distribution of core infarct area between the two groups (P<0.05). There were statistical differences in the FVH score and the MRS score 3 months after discharge between the FVH-DWI matched group and the unmatched group [(2.21±0.65) vs. (4.73±0.78) and (2.59±0.42) vs. (3.18±0.54); both P<0.05]. Conclusions　The higher the FVH score, the higher the degree of FVH-DWI mismatch; the closer its relationship with collateral vessel formation, the better its clinical prognosis.

Key words:

Fluid-attenuated inversion recovery, Vascular high signal intensity, Collateral vessel, Clinical prognosis

摘要：

目的　探讨磁共振液体衰减反转恢复（FLAIR）序列血管高信号征（FVH）与预后的临床意义。方法　选取灌南县第一人民医院及南京中医药大学连云港附属医院2020年1月至2022年12月经门急诊以急性缺血性脑卒中（发病时间<72 h）收治入院患者共100例，依据有无FVH征象，分成FVH阳性组与FVH阴性组。FVH阴性组患者40例，男22例，女18例，年龄（65.49±12.13）岁；FVH阳性组60例，男33例，女27例，年龄（66.32±15.21）岁。分别于入院时及入院后第15天采用美国国立卫生研究院卒中量表（NIHSS）以及卒中后3个月功能改良Rankin量表（MRS）评分判定神经功能缺损程度，并对两组梗死面积大小进行比较。进一步对FVH征阳性分布情况与磁共振扩散加权成像（DWI）核心梗死区进行匹配，分为匹配组和不匹配组，比较两组出院3个月后MRS评分。采用t检验、秩和检验、χ²检验进行比较。结果　FVH阳性组入院当天、入院后第15天NIHSS评分及出院3个月MRS评分分别为（9.49±1.32）分、（7.82±1.45）分、（3.48±1.22）分，FVH阴性组分别为（10.26±1.21）分、（9.54±1.32）分、（4.81±1.32）分，差异均有统计学意义（均P<0.05）；FVH阴性组大面积梗死占55.00%（22/40），FVH阳性组占18.33%（11/60），两组核心梗死区面积大小分布比较差异有统计学意义（P<0.05）。FVH-DWI匹配组和不匹配组FVH评分［（2.21±0.65）分比（4.73±0.78）分］及出院3个月后MRS评分［（2.59±0.42）分比（3.18±0.54）分］比较，差异均有统计学意义（均P<0.05）。结论　FVH评分越高，FVH-DWI不匹配程度越高，其与侧支血管形成的关系越密切，其临床的预后越好。

关键词:

液体衰减反转恢复, 高信号血管征, 侧支血管, 临床预后