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| Clinical Study on the Value of 3.0T MRI in Assessing Neurological Impairment and Hemorrhagic Transformation in Acute Cerebral Infarction |
| ZHANG Nan, SHI Zhichao, WANG Jing, et al |
| Shijiazhuang People's Hospital, Hebei Shijiazhuang 050000, China |
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Abstract Objective: To explore the value of 3.0T magnetic resonance imaging (MRI) in assessing neurological injury in acute cerebral infarction (ACI) and to analyze its predictive value for hemorrhagic transformation (HT), providing a reference for clinical improvement of prognosis.Methods: A total of 104 ACI patients admitted to our hospital from January 2022 to March 2023 were selected. All subjects underwent 3.0T MRI examination of the head. According to the NIHSS score, the degree of neurological impairment was divided into three subgroups: mild group (<7 points, 34 cases), moderate group (7-14 points, 44 cases), and severe group (>14 points, 26 cases). Additionally, based on the results of the 3.0T MRI examination 7-10 days after onset, the patients were divided into two subgroups: HT group (31 cases) and non-HT group (73 cases). The 3.0T MRI parameters of ACI patients in different subgroups were compared, and their relationship with neurological impairment and HT was analyzed to further assess the degree of neurological impairment and predict the risk of HT.Results: The VRA and FA in the mild group (0.15±0.03, 0.30±0.08) were greater than in the moderate group (0.13±0.03, 0.24±0.06), which in turn were greater than in the severe group (0.06±0.02, 0.12±0.03) (F=82.774, 63.120, P<0.05); the Vp, Kep, Ve, and ktrans in the mild group (0.19±0.06, 0.57±0.17, 0.29±0.08, 0.43±0.13) were less than in the moderate group (0.32±0.09, 0.78±0.22, 0.47±0.14, 0.69±0.18), which in turn were less than in the severe group (0.45±0.11, 0.93±0.24, 0.75±0.17, 0.83±0.20) (F=65.855, 22.384, 88.892, 43.605, P<0.05); the VRA and FA in the HT group (0.08±0.02, 0.19±0.06) were lower than in the non-HT group (0.13±0.03, 0.31±0.09) (t=9.972, 7.978, P<0.05); the Vp, Kep, Ve, and ktrans in the HT group (0.38±0.11, 0.85±0.25, 0.56±0.14, 0.72±0.21) were higher than in the non-HT group (0.16±0.05, 0.52±0.16, 0.28±0.08, 0.44±0.21) (t=14.065, 8.063, 12.881, 6.220, P<0.05); the 3.0T MRI parameters VRA and FA were negatively correlated with neurological impairment and HT in ACI patients (r1=-0.641, -0.627, r2=-0.625, -0.611, P<0.05), while Vp, Kep, Ve, and ktrans were positively correlated with neurological impairment and HT in ACI patients (r1=0.701, 0.579, 0.754, 0.688, r2=0.673, 0.589, 0.670, 0.583, P<0.05); the combined prediction of VRA, FA, Vp, Kep, Ve, and ktrans for severe neurological impairment had the largest AUC of 0.913 (95%CI: 0.841-0.959), with a sensitivity of 84.62% and specificity of 87.18% (P<0.05), and the combined prediction of these 3.0T MRI parameters for the occurrence of HT in ACI patients had the largest AUC of 0.925 (95%CI: 0.857-0.968), with a sensitivity of 90.32% and specificity of 79.45% (P<0.05).Conclusion: The 3.0T MRI examination parameters are closely related to neurological impairment and HT in ACI patients, and the combination of VRA, FA, Vp, Kep, Ve, and ktrans has a high predictive value for severe neurological impairment and HT occurrence, which is of clinical guidance significance.
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2024, Vol. 30 
