The predictive value of quantitative parameters from magnetic resonance perfusion imaging combined with serum tenascin-C in evaluating the prognosis of patients with large hemispheric infarction
Liu Xu
Zheng Cun
Zhao Pengfei
Li Menglong
Abstract：Objective To explore the prognostic value of quantitative parameters from magnetic resonance perfusion weighted imaging(PWI)combined with serum tenascin-C(TN-C)in patients with large hemispheric infarction(LHI).Methods Clinical data of 142 patients with LHI were analyzed retrospectively,who were divided into a poor prognosis group(n=65)and a good prognosis group(n=77)based on clinical outcomes.Receiver operating characteristic(ROC)curves were used to determine the threshold values of LHI quantitative parameters,including relative mean transit time(rMTT),relative time to peak(rTTP),relative cerebral blood flow(rCBF),and relative cerebral blood volume(rCBV).Logistic regression analysis was conducted to identify independent risk factors for prognosis.The predictive values of these factors were evaluated using the probability values derived from the regression model.Results Multivariate logistic regression analysis revealed that rMTT≥1.135,rTTP≥1.185,rCBF≤1.105,rCBV≤0.985,white blood cell(WBC)count,and TN-C were independent risk factors influencing the prognosis of LHI patients(all P<0.05).ROC curve analysis demonstrated that rMTT,rTTP,rCBF,rCBV,WBC,TN-C,the combination of PWI parameters with TN-C,and combined prediction were all statistically significant in predicting the prognosis of LHI patients(all P<0.05).Among these,the area under the curve(AUC)for the combination of PWI parameters with TN-C was 0.958(95%CI:0.928-0.989),with a sensitivity of 0.908 and a specificity of 0.935.The AUC for the combined prediction was 0.963(95%CI:0.933-0.992),with a sensitivity of 0.938 and a specificity of 0.922.Conclusions The combination of PWI quantitative parameters with serum TN-C exhibits good prognostic value for LHI patients,surpassing the predictive ability of single indicators.rMTT≥1.135,rTTP≥1.185,rCBF≤1.105,rCBV≤0.985,WBC count,and TN-C are independent risk factors influencing the prognosis of LHI patients,suggesting that timely targeted treatment should be administered to patients with these risk factors.
Keywords：brain infarctionmagnetic resonance perfusion imagingtenascin-Cprognosisprognostic factors
Publication Date：2025-05-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 290-297 )