Magnetic resonance 3D-pcASL perfusion imaging combined with DWI in differential diagnosis of hyper-acute and acute ischemic cerebral infarction

LIU Yang; DAI Zhenyu; DONG Congsong; YAO Lizheng; CHEN Fei; ZHANG Zhiping; PAN Wenyan

Abstract：Objective To explore the clinical application value of magnetic resonance 3D pseudo continuous arterial spin labeling (3D-pcASL) perfusion imaging combined with DWI in differential diagnosis of hyper-acute and acute ischemic cerebral infarction.Methods We retrospectively analyzed MRI images of 20 patients with hyper-acute ischemic cerebral infarction (group A) and 36 patients with acute ischemic cerebral infarction (group B) from the our hospital.Then,we measured the abnormal perfusion area (SCBF) on cerebral blood flow (CBF) images from 3D-pcASL and the abnormal increased signal intensity area on DWI images (SDWI) at the maximum infarction slice,calculated the theoretical ischemic penumbra (IP),compared the differences of CBF,ADC value of infarction core (IC),IP between lesion and contra and,also,analyzed the differences of the lesionscontra relative values (rCBF and rADC) between two groups.Results In IC,three cases were high perfusion (zero case in group A,3 cases in group B),nine cases were equal perfusion (1 case in group A,8 cases in group B),and forty-four cases were low perfusion (19 cases in group A,25 cases in group B).There were forty-one cases of SCBF ＞ SDWI (19 cases in group A,22 cases in group B),fifteen cases of SCBF ≈ SDWI (1 case in group A,14 cases in group B),and zero case of SCBF ＜ SDWI.The CBF and ADC value of IC were lower than contra in both two groups (P ＜ 0.05).The CBF value of theoretical IP in both two groups and the ADC value of theoretical IP in group A were lower than that of contra (P ＜ 0.05).The rADC of IC in group A was higher than that in group B.On the contrary,the rCBF and rADC of IP in group A were decreased than that in group B (P ＜ 0.05).Conclusion In clinic,the use of 3D-pcASL combined with DWI is able to make the differential diagnosis of acute cerebral infarction without clear onset time,which can benefit the timely selecting more reasonable individualized treatment project.