医学影像学杂志

目的 探讨磁共振弥散加权成像（MRI-DWI）联合液体衰减反转恢复（FLAIR）序列对急性脑梗死（ACI）患者急诊阿替普酶静脉溶栓疗效的评估作用。方法 选取医院急诊收治的116例ACI患者，所有患者入院后均接受阿替普酶静脉溶栓治疗，于溶栓治疗后24 h采用美国国立卫生研究院卒中量表（NIHSS）评估疗效。比较不同疗效患者静脉溶栓前检测的MRI-DWI、FLAIR检查参数，通过受试者工作特征曲线（ROC曲线）探讨MRI-DWI、FLAIR对ACI患者急诊阿替普酶静脉溶栓疗效的评估作用。结果 116例接受阿替普酶静脉溶栓ACI患者疗效良好组95例（81.90%），疗效欠佳组21例（18.10%）。疗效欠佳组脑梗死体积较疗效良好组大，ADC值、rADC值较疗效良好组小，差异有统计学意义（P<0.05）。组间高信号血管征对比，差异无统计学意义（P>0.05）。绘制ROC曲线，提示MRI-DWI联合FLAIR评估ACI患者急诊阿替普酶静脉溶栓疗效的曲线下面积（AUC）值为0.895，评估价值较高。结论 MRI-DWI联合FLAIR评估ACI患者急诊阿替普酶静脉溶栓疗效的价值较高，可为临床诊疗方案的优化提供帮助。

Objective To explore the evaluation effect of magnetic resonance imaging-diffusion weighted imaging(MRIDWI) combined with fluid attenuated inversion recovery(FLAIR) sequence on the efficacy of emergency alteplase intravenous thrombolysis in patients with acute cerebral infarct(ACI). Methods 116 ACI patients admitted were selected as the study subjects. All patients received intravenous thrombolysis with alteplase after admission, and the efficacy was evaluated using the National Institutes of Health Stroke Scale(NIHSS) 24 hours after thrombolysis. The MRI-DWI and FLAIR parameters detected before intravenous thrombolysis in patients with different efficacy were compared. The receiver operating characteristic curve(ROC curve) was used to explore the evaluation effect of MRI-DWI and FLAIR on the efficacy of intravenous thrombolysis with alteplase in patients with ACI. Results According to statistics, 95 cases(81.90%) of 116 ACI patients who received alteplase intravenous thrombolysis had good therapeutic effects, while, 21 cases(18.10%) had poor therapeutic effects. The volume of cerebral infarction in the group with poor therapeutic effect was larger than that in the group with good therapeutic effect, and the ADC and rADC values were smaller than those in the group with good therapeutic effect, with statistical significant differences(P<0.05). There was no statistical significant difference in the comparison of high signal vascular signs between groups(P>0.05). ROC curve was drawn, suggesting that the area under the curve(AUC) value of MRI-DWI combined with FLAIR in evaluating the efficacy of acute alteplase intravenous thrombolysis in ACI patients was 0.895, and the evaluation value was high.Conclusion The combination of MRI-DWI and FLAIR has high value in evaluating the efficacy of emergency alteplase intravenous thrombolysis in ACI patients, which can provide assistance for optimizing clinical diagnosis and treatment plans.