目的:探讨磁共振T2-液体衰减反转恢复(T2-FLAIR)序列中高信号血管征(HVS)联合三维动脉自旋标记(3D-ASL)脑灌注成像技术中动脉穿行伪影(ATA)在评估急性缺血性脑卒中(AIS)患者侧支循环及临床预后中的价值。方法:收集山东第一医科大学第二附属医院神经内科自2017年9月至2019年11月收治的101例AIS患者进入研究。根据血管狭窄程度将101例患者分为大脑中动脉(MCA)阳性组(狭窄程度≥50%)(60例)及阴性组(狭窄程度<50%)(41例)，并根据是否出现ATA征象将MCA阳性组患者进一步分为ATA(+)组(33例)及ATA(-)组(27例)。记录不同组别患者缺血半暗带(IP)区脑血流灌注值(CBF)，入院及出院时美国国立卫生研究院卒中量表(NIHSS)评分，并计算相对脑血流灌注量(rCBF)及出院时NIHSS评分降度，对比分析2种征象与临床预后的关系。结果:MCA阳性组与MCA阴性组患者HVS分级、rCBF、出入院NIHSS评分及评分降度差异均有统计学意义(n P<0.05)。60例MCA阳性组患者中HVS分级为0级16例，Ⅰ级14例，Ⅱ级17例，Ⅲ级13例，不同分级患者中rCBF及NIHSS评分降度差异有统计学意义(n P<0.05)，HVS级数越高，患者rCBF及NIHSS评分降度越大。Spearman相关性分析显示HVS分级与rCBF呈高度正相关(n rn s=0.808，n P=0.000)，与出院时NIHSS评分降度呈中度正相关(n rn s=0.737，n P=0.000)。ATA(+)组患者rCBF、NIHSS评分降度大于ATA(-)组患者，出院时NIHSS评分低于ATA(-)组患者，差异均有统计学意义(n P<0.05)。Spearman相关性分析显示ATA与rCBF及出院NIHSS评分降度之间呈中度正相关(n rn s=0.403，n P=0.001，n rn s=0.550，n P=0.000)；rCBF及出院NIHSS评分降度呈高度正相关(n rn s=0.827，n P=0.000)。受试者工作特征曲线显示ATA与HVS对评估脑血流灌注改变的敏感度分别为83.3%与66.7%，特异度分别为52.1%与89.6%，二者联合评估的敏感度为83.3%，特异度为64.6%。n 结论:HVS征象联合ATA征象可有效评估IP区血流灌注情况及患者预后。“,”Objective:To explore the application values of arterial transit artifact (ATA) showed by 3D arterial spin labeling (3D-ASL) combined with hyperintense vessel sign (HVS) showed by T2-magnetic resonance fluid attenuation inversion recovery (T2-FLAIR) in evaluating collateral circulation and clinical prognoses in patients with acute ischemic stroke (AIS).Methods:One hundred and one AIS patients admitted to our hospital from September 2017 to November 2019 were included in the study. According to the degrees of vascular stenosis, these patients were divided into middle cerebral artery (MCA) positive group (stenosis degree≥50%, n n=60) and MCA negative group (stenosis degree<50%,n n=41); according to whether there was ATA, the MCA-positive patients were divided into ATA(+) group (n n=33) and ATA(-) group (n n=27). The cerebral blood flow (CBF) of the ischemic penumbra (IP) and National Institute of Health stroke scale (NIHSS) scores at admission and at discharge in patients from different groups were recorded; the relative CBF (rCBF) and drop degrees of NIHSS scores at discharge were calculated; a comparative analysis of the relations of ATA and HVS with clinical prognoses was performed.n Results:There were significant differences in HVS grading, rCBF, NIHSS scores at admission and at discharge and drop degrees of NIHSS scores at discharge between MCA positive group and MCA negative group (n P<0.05). Among the 60 patients from MCA-positive group, 16 were classified as HVS grading 0, 14 as HVS grading I, 17 as HVS grading II, and 13 as HVS grading III; there were statistical differences in rCBF and drop degrees of NIHSS scores at discharge among patients with different HVS grading (n P<0.05); the higher the HVS grading was, the greater the decrease of rCBF and drop degrees of NIHSS scores were. Spearman correlation analysis showed that there was a high positive correlation between HVS grading and rCBF (n rn s=0.808, n P=0.000), and a moderate positive correlation between HVS grading and drop degrees of NIHSS scores at discharge (n rn s=0.737, n P=0.000). Patients in the ATA(+) group had significantly greater decrease of rCBF and drop degrees of NIHSS scores, and significantly lower NIHSS scores at discharge as compared with patients from the ATA(-) group (n P<0.05). Spearman correlation analysis showed that ATA had moderate positive correlations with rCBF and drop degrees of NIHSS scores (n rn s=0.403, n P=0.001; n rn s=0.550, n P=0.000); there was a highly positive correlation between rCBF and drop degrees of NIHSS scores (n rn s=0.827, n P=0.000). Receiver operating characteristic curve showed that the sensitivities of ATA and HVS to assess cerebral blood perfusion changes were 83.3% and 66.7%, and the specificities were 52.1% and 89.6%, respectively; the combined sensitivity of the two was 83.3% and the specificity was 64.6%.n Conclusion:HVS combined with ATA can effectively evaluate the perfusion in IP region and prognoses of AIS patients.