Zeng Lichuan, Wang Jiamei, Wang Qu, Zhang Yaodan, Liao Huaqiang, Wu Wenbin
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Deyang Hospital Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Deyang, China.
Front Neurol. 2025 May 14;16:1589198. doi: 10.3389/fneur.2025.1589198. eCollection 2025.
To assess the practicality and utility of employing dual post-label delay (PLD) arterial spin labeling (ASL) in transient ischemic attack (TIA) individuals exhibiting Fluid-attenuated inversion recovery (FLAIR) vascular hyperintensity (FVH).
We conducted a retrospective review of clinical data from TIA patients presenting with unilateral severe atherosclerotic stenosis or obstruction of either the intracranial internal carotid artery or the middle cerebral artery. Participants were categorized into two groups based on the presence or absence of FVH: FVH positive and FVH negative. All individuals underwent pseudo-continuous ASL perfusion imaging, utilizing distinct PLD durations (1,525 and 2,525 ms) alongside qualitative visual assessments of ASL perfusion irregularities. Standardized TIA evaluations, which included medical history reviews, neuropsychological assessments, and ABCD2 scoring, were performed on all subjects. We explored the correlations between FVHs, clinical manifestations, vascular risk factors, and perfusion metrics.
A total of 50 patients were included in this investigation, with FVH detected in 16 subjects (32.0%). The ABCD2 score was notably elevated within the FVH positive cohort compared to the FVH negative group. At a PLD of 1,525 ms, cerebral blood flow (CBF) values for the affected and healthy hemispheres in the FVH positive group were recorded at 19.55 ± 6.67 and 40.32 ± 6.83, respectively; corresponding values in the FVH negative group were 23.74 ± 5.03 and 46.43 ± 7.91. For a PLD of 2,525 ms, the CBF values for the affected and healthy sides in the FVH positive group were 34.11 ± 5.87 and 50.27 ± 8.57, while the FVH negative group recorded values of 42.79 ± 7.03 and 52.07 ± 7.29, respectively. The differential CBF (ΔCBF) for the affected side in the FVH positive and negative groups was 14.57 ± 4.34 and 19.05 ± 6.10, respectively. A significant negative correlation was established between ΔCBF and ABCD2 scores (Kendall's tau-b = -0.578, < 0.001).
The findings of this study indicate a strong association between the presence of FVH signs and a marked reduction in cerebral blood flow, as well as diminished blood flow reserve. This underscores the potential role of FVH as a biomarker for hemodynamic impairment in TIA patients.
评估在表现出液体衰减反转恢复序列（FLAIR）血管高信号（FVH）的短暂性脑缺血发作（TIA）患者中采用双后标记延迟（PLD）动脉自旋标记（ASL）的实用性和效用。
我们对患有颅内颈内动脉或大脑中动脉单侧严重动脉粥样硬化狭窄或闭塞的TIA患者的临床资料进行了回顾性研究。参与者根据FVH的有无分为两组：FVH阳性组和FVH阴性组。所有个体均接受伪连续ASL灌注成像，使用不同的PLD持续时间（1525和2525毫秒）以及对ASL灌注异常的定性视觉评估。对所有受试者进行标准化的TIA评估，包括病史回顾、神经心理学评估和ABCD2评分。我们探讨了FVH、临床表现、血管危险因素和灌注指标之间的相关性。
本研究共纳入50例患者，其中16例（32.0%）检测到FVH。与FVH阴性组相比，FVH阳性队列中的ABCD2评分显著升高。在PLD为1525毫秒时，FVH阳性组患侧和健侧的脑血流量（CBF）值分别记录为19.55±6.67和40.32±6.83；FVH阴性组的相应值为23.74±5.03和46.43±7.91。对于PLD为2525毫秒，FVH阳性组患侧和健侧的CBF值分别为34.11±5.87和50.27±8.57，而FVH阴性组记录的值分别为42.79±7.03和52.07±7.29。FVH阳性组和阴性组患侧的差异脑血流量（ΔCBF）分别为14.57±4.34和19.05±6.10。ΔCBF与ABCD2评分之间建立了显著的负相关（肯德尔tau-b=-0.578，P<0.001）。
本研究结果表明FVH体征的存在与脑血流量显著减少以及血流储备减少之间存在密切关联。这强调了FVH作为TIA患者血流动力学损害生物标志物的潜在作用。
