目的

急性缺血性脑卒中早期准确评估梗死核心及缺血半暗带的体积对治疗决策至关重要。本文旨在比较多延迟动脉自旋标记成像与CT灌注成像在评估这些病灶体积方面的准确性与一致性。

方法

回顾性收集2021年7月～ 2023年9月在首都医科大学宣武医院诊治的36例AIS患者的临床资料，所有患者均接受多延迟ASL与CTP检查（两项检查时间间隔＜24 h）。分析患者的ASL与CTP图像，采用符号秩检验比较两种方法在测量梗死核心及缺血半暗带体积上的差异，利用组内相关系数评估两种方法在测量这些指标时的一致性。

结果

多延迟ASL与CTP测得的梗死核心体积分别为12.56[7.99，37.59]和10.50[6.00，37.00]，差异无统计学意义（P＞0.05）。多延迟ASL与CTP测得的缺血半暗带体积分别为124.94[94.67，150.16]和116.00[83.00，151.00]，差异亦无统计学意义（P＞0.05）。两种方法在测量梗死核心和缺血半暗带体积时的ICC分别为0.967和0.949，表明两者具有高度一致性。

结论

多延迟ASL与CTP在AIS患者中的诊断准确性较高且一致性良好，尤其是对于梗死核心和缺血半暗带的评估。多延迟ASL作为一种有效的影像学方法，具有推广应用的潜力，值得在临床实践中进一步探索。

Objective

Early and accurate assessment of infarct core and ischemic penumbra volume is crucial for treatment decisions in acute ischemic stroke (AIS). This study aimed to compare the accuracy and consistency of multi-delay arterial spin labeling (ASL) and computed tomography perfusion(CTP) in evaluating the volumes of these lesion.

Methods

A retrospective analysis was conducted on 36 AIS patients who were admitted to Xuanwu Hospital of Capital Medical University between July 2021 and September 2023. All patients underwent both multi-delay ASL and CTP scans (with an interval of＜24 hours between the two examinations). The ASL and CTP images were analyzed, and the differences in infarct core and ischemic penumbra volumes measured by the two modalities were compared using the Wilcoxon signedrank test. Intraclass correlation coefficient (ICC) was used to assess the consistency of the two methods in measuring these volumes.

Results

The infarct core volumes measured by multi-delay ASL (12.56 [7.99,37.59]) and CTP (10.50 [6.00, 37.00]) showed no statistically significant difference (P＞0.05). Similarly,the ischemic penumbra volumes measured by multi-delay ASL (124.94 [94.67, 150.16]) and CTP (116.00[83.00, 151.00]) also showed no significant difference (P＞0.05). The ICC for measuring infarct core and ischemic penumbra volumes by the two methods were 0.967 and 0.949, respectively, indicating a high level of consistency.

Conclusion

Both multi-delay ASL and CTP demonstrate high diagnostic accuracy and good consistency in evaluating infarct core and ischemic penumbra volumes in AIS patients. Multi-delay ASL is a promising imaging method with potential for clinical application and further exploration.