Correlation between different matching of perfusion weighted imaging- diffusion weighted imaging and effect of defibrase in treatment of acute cerebral infarction

Abstract

Objective To investigate the correlation between different matching of magnetic resonance (MR) perfusion weighted imaging (PWI)- diffusion weighted imaging (DWI) and the effect of defibrase in the treatment of acute cerebral infarction. Methods Sixty- eight patients with acute cerebral infarction, who were hospitalized in our hospital between January 2015 and January 2017, were included in the study, and underwent defibrase therapy. All patients underwent PWI and DWI scans at hospitalization, and the abnormal area ranges showed by PWI and DWI were compared. The National Institutes of Health Stroke Scale (NIHSS) was used to determine the neurological deficit score at the baseline and at 7 d after the treatment, and the clinical effect was evaluated. According to matching of the abnormal area ranges showed by PWI and DWI, all patients were divided into 4 groups: PWI>DWI group (no match>20%) ,PWI=DWI group (mismatch within ± 20%) , PWI<DWI group (mismatch<- 20%) , and normal group (PWI- DWI matched normal) . The clinical effects in the four groups were compared at 7 d after the treatment. The patients were divided into groups according to the factors such as gender, age, smoking, alcohol consumption, hypertension, diabetes, infarction site, basic NIHSS score, duration of disease, combined hyperbaric oxygenation, admission hypertension, admission hyperglycemia, hyperuricemia and PWI- DWI matching. The relationship between NIHSS score decline and various factors at 7 d after the treatment was analyzed. Multivariate linear regression analysis was used to analyze the risk factors influencing the effect of defibrase therapy. Results According to the PWI-DWI matching, 68 patients with acute cerebral infarction were divided into the PWI>DWI group (n=38) , PWI=DWI group (n=15) , PWI DWI group was significantly better than that in the PWI<DWI group (χ2=26.04, P<0.05) . At 7 d after the treatment, there was a correlation between the NIHSS score decline and smoking, alcohol consumption, diabetes, infarction site, duration of disease, combined hyperbaric oxygenation , admission hypertension , admission hyperglycemia , hyperuricemia and PWI-DWI matching (all P <0.05 ) . The multivariate linear regression analysis showed that the duration of disease (β=- 7.146 , P=0.016) , admission hypertension (β =10.56 , P=0.014) and PWI- DWI matching (β=-8.570, P=0.001) were the risk factors influencing the effect of defibrase therapy. Conclusion There are many risk factors influencing the effect of defibrase therapy in patients with acute cerebral infarction. The matching of PWI-DWI can be used to predict the effect of defibrase therapy. Key words: Brain infarction; Magnetic resonance imaging; Perfusion weighted imaging; Diffusion weighted imaging