分子影像学杂志2026，Vol.49Issue(5)：630-636,7.DOI:10.12122/j.issn.1674-4500.2026.05.10
急性缺血性脑卒中患者早期神经功能恶化的预测:基于MRI的高信号血管征、脑白质高信号体积及表观扩散系数
Prediction of early neurological deterioration in patients with acute ischemic stroke:based on MRI hyperintense vessel sign,white matter hyperintensity volume and apparent diffusion coefficient
摘要
Abstract
Objective To investigate the predictive value of hyperintense vessel sign(HVS),white matter hyperintensity(WMH)volume and apparent diffusion coefficient(ADC)value based on MRI on early neurological deterioration(END)in patients with acute ischemic stroke(AIS).Methods A total of 120 patients with AIS admitted to the hospital from May 2024 to May 2025 were collected.According to whether END occurred within 7 days of admission,they were divided into occurrence group and non-occurrence group.The general data of patients were collected,and the laboratory parameters such as neutrophil percentage(NEUT%),high-sensitivity C-reactive protein(hs-CRP),fibrinogen(FIB)and D-dimer(D-D)were detected.All patients completed cranial MRI within 24 h after admission to evaluate the positive rate of HVS,WMH volume and ADC value.Pearson/Spearman correlation analysis was used to explore the correlation between MRI parameters and END-related indicators.Receiver operating characteristic curve was used to evaluate the predictive value of HVS,WMH volume and ADC value on END.Results The maximum National Institutes of Health Stroke Scale(NIHSS)score within 7 days of admission in occurrence group was higher than that in occurrence group(P<0.05).NEUT%,FIB,D-D and hs-CRP were higher in occurrence group than those in non-occurrence group(P<0.05).The positive rate of HVS in occurrence group was higher,and the volume of WMH was larger,and the ADC value was lower(P<0.05).The positive rate of HVS in AIS patients with END was positively correlated with maximum NIHSS score within 7 days of admission,and WMH volume was positively correlated with NEUT%,D-D,hs-CRP and maximum NIHSS score within 7 days of admission,and ADC value was negatively correlated with NEUT%,D-D and maximum NIHSS score within 7 days of admission(P<0.05).The combined prediction had the highest predictive efficiency on END in AIS patients,with a Youden index of 0.689,an area under the curve of 0.898,a sensitivity of 92.86%and a specificity of 76.09%.Conclusion MRI-based HVS,WMH volume and ADC value are associated with END in AIS patients.The combined detection of the three has high predictive value on END in AIS patients,and can provide a reference for clinical identification of END patients.关键词
急性缺血性脑卒中/早期神经功能恶化/磁共振成像/高信号血管征/脑白质高信号/表观扩散系数Key words
acute ischemic stroke/early neurological deterioration/magnetic resonance imaging/hyperintense vessel sign/white matter hyperintensity/apparent diffusion coefficient引用本文复制引用
王秀萍,胡珊珊,黄银生..急性缺血性脑卒中患者早期神经功能恶化的预测:基于MRI的高信号血管征、脑白质高信号体积及表观扩散系数[J].分子影像学杂志,2026,49(5):630-636,7.基金项目
浙江省医药卫生科技计划项目(2023XY222) （2023XY222）
