Comparative analysis of diagnostic application of perfusion imaging with DWI, 3D-TOF MRA and 3D-ASL in senile ischemic cerebrovascular diseases

Objective To explore the diagnostic value of magnetic resonance diffusion weighted imaging(DWI), 3D time of flight magnetic resonance angiography(3D-TOF MRA), and 3D arterial spin labeled MR perfusion imaging(3D-ASL)in the senile ischemic cerebrovascular diseases. Methods Ninety patients with acute cerebral infarction and 69 with transient ischemic attack were retrospectively analyzed based on data of DWI, 3D-TOF MRA and 3D-ASL MRI.Additionally, 60 healthy individuals were recruited as a control group.SPSS 21.0 statistical software was used. Results In 90 acute cerebral infarction(ACI)group, the 3D-ASL MRI showed hypoperfusion in 85 patients, hyperperfusion in 2 patients, and no apparently perfusion abnormality in 3 patients.In 85 hypoperfusion patients, the average hypoperfusion area showed by 3D-ASL MRI was(2 543±1 133)mm2, which was higher than the area of high signal in DWI(817±413)mm2(P DWI in 83 cases and ASL≈DWI in 2 cases.In 69 transient ischemic attack patients, 25 patients had artery stenosis and abnormal ASL, 11 patients had artery stenosis and normal ASL, 17 patients had normal vascular and abnormal ASL, 15 had normal vascular and normal ASL.The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were higher in 3D-TOF MRA combined with 3D-ASL than in their individual inspection(χ2=10.35, P<0.01, P<0.05), and the rates of missed diagnosis and misdiagnosis were lower in 3D-TOF MRA combined with 3D-ASL than in their individual inspection(χ2=4.93, P<0.05). Conclusions ASL, MRA, and DWI can reflect the different characteristics of the senile ischemic cerebrovascular diseases, and should be used as the standard sequence in geriatric neurology to provide more comprehensive information for the diagnosis and treatment of senile ischemic cerebrovascular disease. Key words: Brain ischemia; Diffusion magnetic resonance imaging; Imaging, three-dimensional