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目的评估磁敏感加权成像(SWI)皮层血管征(CVS)对急性缺血性脑卒中(AIS)缺血半暗带(IP)的诊断价值。方法 47例AIS患者发病72h内行SWI、磁共振弥散加权成像(DWI)和磁共振灌注加权成像检查。将CVS与灌注-弥散不匹配(PDM)进行比较,评价CVS对IP的诊断价值。采用阿尔伯特早期CT评分量表分别对SWI-DWI不匹配(SDM)和PDM进行量化评分,评价两者分布区域的一致性。结果 47例AIS患者中,16例(34.04%)存在CVS,19例(40.43%)患者存在PDM。以PDM为金标准,CVS诊断IP的灵敏度为84.21%,特异度为100%,阳性预测值为100%,阴性预测值为90.32%。PDM评分为(3.19±1.05)分,SDM评分为(3.25±1.13)分,两者分布区域无统计学差异(P>0.05)。结论 CVS可作为无创性评估AIS患者IP简单、有效的影像学指标。
Objective To evaluate the value of magnetic resonance weighted imaging (SWI) cortical vascular sign (CVS) in the diagnosis of acute ischemic stroke (AIS) ischemic penumbra (IP). Methods Forty-seven AIS patients were examined by SWI, DWI and MR perfusion weighted imaging within 72 hours. CVS was compared with Perfusion-Dispersion Mismatch (PDM) to evaluate the diagnostic value of CVS for IP. The early Alberta CT scoring scale was used to quantify the SWI-DWI mismatch (SDM) and PDM respectively to evaluate the consistency of the distribution of the two. Results Of the 47 AIS patients, 16 (34.04%) had CVS and 19 (40.43%) had PDM. With PDM as the gold standard, the sensitivity of CVS in diagnosing IP was 84.21%, the specificity was 100%, the positive predictive value was 100% and the negative predictive value was 90.32%. PDM score was (3.19 ± 1.05), SDM score was (3.25 ± 1.13) points, there was no significant difference between the two distribution areas (P> 0.05). Conclusions CVS can be used as a simple and effective imaging index for noninvasive assessment of IP in patients with AIS.