Evaluation value of adverse prognosis after intravenous thrombolysis in patients with acute cerebral infarction using MRI-SWI combined with cerebral CT perfusion imaging

LIANG Xiaohui; LIANG Ling; QI Xinxin

doi:10.20258/j.cnki.1006-9011.2025.05.004

Abstract：Objective To explore the evaluation value of susceptibility weighted imaging(MRI-SWI)combined with cere-bral CT perfusion imaging(CTP)for adverse prognosis after intravenous thrombolysis in patients with acute cerebral infarction(ACI).Method A study was conducted on 157 ACI patients.All patients underwent MRI-SWI,CTP,and other examinations upon admission.After a clear diagnosis was made,all patients received intravenous thrombolysis with Ateplase.At 3 months af-ter intravenous thrombolysis treatment,the prognosis was evaluated using the Modified Rankin Scale(MRS)and divided into a poor prognosis group(MRS≥2 points)and a good prognosis group(MRS<2 points)based on the MRS score.Then,we compared the phase value(PV)of MRI-SWI parameters,mean transit time(MTT),cerebral blood volume(CBV),cerebral blood flow(CBF),time to peak(TTP)of the brain CTP parameters,drew the receiver operating characteristic(ROC)curve,and analyzed the evaluation of MRI-SWI combined with brain CTP in assessing the poor prognosis of ACI patients after intravenous thrombolysis.Results 54 out of 157 ACI patients had poor prognosis,103 cases had a good prognosis.PV,MTT,and TTP of the poor progno-sis group were higher than those of the good prognosis group(P<0.05).CBV and CBF were lower in the good prognosis group(P<0.05).ROC curves showed that the area under the curve(AUC)values for evaluating the adverse prognosis of ACI patients after intravenous thrombolysis using MRI-SWI and brain CTP examination parameters alone and in combination were 0.704,0.698,0.711,0.706,0.670,and 0.880,respectively,with the highest combined evaluation value.Conclusion The combination of MRI-SWI and brain CTP has a high value in evaluating the adverse prognosis of ACI after intravenous thrombolysis,which can provide reference for the development of preventive intervention plans for ACI patients with high risk of poor prognosis in clinical practice.