SWI combined with dual post-labelling delay 3D-ASL can effectively assess the perfusion status in patients with acute cerebral infarction
TAN Can
HUANG Lijuan
QIU Weijia
CHEN Peng
WEI Yin
Abstract：Objective To investigate the clinical significance of susceptibility-weighted imaging(SWI)combined with dual post-labelling delay(PLD)3D arterial spin labelling(3D-ASL)technique for evaluating patients with acute cerebral infarction and predicting early infarct growth.Methods Thirty-two patients with acute ischaemic cerebral infarction underwent routine MRI,DWI,SWI and 3D-ASL(PLD of 1.5 s and 2.5 s)within 24 h after onset.Among these patients,21 were re-examined with routine MRI and DWI on day 7 after onset.The following parameters were recorded:NIHSS scores,prominent venous signs(PVS)and scores,DWI infarct size,the bilateral cerebral blood flow(CBF)values(infarct area and mirror area,peri-infarct area and mirror area),rCBF values(CBF value on the affected side/CBF value on the mirror side),ischaemic penumbra area(PLD of 1.5 s and 2.5 s),increase in DWI infarct size between two examinations and 90 d modified Rankin scale(mRS)scores.The patients were divided into PVS positive and PVS negative groups according to the presence of PVS.The differences in imaging parameters among 32 patients were analysed,and Spearman correlation was used to detect the correlation of cerebral infarction growth values with SWI and ASL parameters in 21 patients.Results Significant differences in the first NIHSS score,DWI infarct size,CBF1.5 s peri-infarct area,rCBF1.5 s peri-infarct area,rCBF2.5 s peri-infarct area,CBF2.5 s infarct area,rCBF2.5 s infarct area,PLD 1.5 s and 2.5 s ischaemic penumbra area,difference in PLD 1.5-2.5 s penumbra area and increase in infarct size after 7 d were observed between the PVS positive and negative groups(P<0.05).Specifically,the increase in infarct size was positively correlated with the PVS score,DWI infarct size,and ischaemic penumbra areas(PLD of 1.5 s and 2.5 s)at the first examination(P<0.05)but negatively correlated with the rCBF1.5 s infarct area,rCBF1.5 s peri-infarct area,rCBF2.5 s infarct area and rCBF2.5 s peri-infarct area(P<0.05).Conclusion SWI-based examination of PVS reflects low blood perfusion,large infarct size,large ischaemic penumbra area and high admission severity,demonstrating a certain predictability for the short-term increase in infarct size.Combined with ASL multimodality functional imaging,this approach can provide an accurate assessment of the blood perfusion status in the infarct area and hypoxia in brain tissue,making it crucial for guiding treatment decisions and prognosis in clinical practice.
Keywords：susceptibility-weighted imagingthree-dimensional arterial spin labellingprominent venous signsacute cerebral infarctioninfarct growth
Publication Date：2025-01-27
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 51-57 )