Analysis of cerebral blood flow perfusion status and its relationship with prognosis in patients with ischemic stroke based on three-dimensional arterial spin labeling imaging technology

LI Jianqing; YI Wenbin; LIU Ke; LIANG Ying; YANG Yingxing; ZHANG Mengting; YE Feng

doi:10.20258/j.cnki.1006-9011.2025.09.008

Abstract：Objective To analyze the cerebral blood flow perfusion status and its relationship with the prognosis of ischemic stroke(AIS)patients based on three-dimensional arterial spin labeling imaging technology(3D-ASL),in order to provide refer-ence for the diagnosis and treatment evaluation of AIS.Methods 97 AIS patients were selected as the study group,and another 97 healthy individuals who underwent physical examinations during the same period were selected as the control group.Patients in both groups underwent 3D-ASL examination so as to observe and compare the cerebral blood flow perfusion status,including normal cerebral blood flow perfusion,low perfusion,high perfusion rate,and rCBF values,between the two groups.The CBF values at points 3,6,9,and 12 in the high signal area and surrounding low signal area of DWI on the affected and healthy sides were studied in the study group.We followed up those patients for 6 months and compared the CBF values of DWI high signal area and surrounding low signal area at 3,6,9,and 12 points in AIS patients with poor prognosis(mRS score≥3 points,n=24)and good prognosis(mRS score≤2 points,n=73).Logistic regression analysis was used to investigate the correlation be-tween CBF values and poor prognosis in AIS patients.Results Compared with the control group,the study group had a lower normal cerebral blood flow perfusion rate and rCBF value,and a higher low perfusion rate(P<0.05).The CBF values at points 3,6,9,and 12 in the DWI high signal area and surrounding low signal area on the healthy side of the research group were higher than those on the affected side(all P<0.01).AIS patients with good prognosis had higher CBF values at points 3,6,9,and 12 in the DWI high signal area and surrounding low signal area compared to those with poor prognosis(P<0.01).The results of logistic regression analysis showed that low CBF values at points 3,6,9,and 12 in the DWI high signal area and surrounding low signal area were independent risk factors for poor prognosis in AIS(all P<0.05).Conclusion 3D-ASL has high value in as-sessing cerebral blood flow perfusion changes in AIS patients,which can clarify cerebral blood flow perfusion characteristics,aiding in treatment and prognosis evaluation.