Objective: To investigate the application of magnetic resonance 3D arterial spin labeling (3D-ASL) imaging in the hemodynamic analysis and prognostic assessment of vascular cognitive impairment (VCI).
Methods: Using a retrospective research method, 108 patients with ischemic cerebrovascular disease diagnosed in the Department of Neurology of Lianyungang Hospital of Traditional Chinese Medicine from January 2021 to April 2022 were chose as the research subjects. The Montreal cognitive assessment (MoCA) was used to evaluate cognitive function. The patients were divided into a VCI group (n=54, 28 males and 26 females) and a normal cognitive function group (NCF group, n=54, 30 males and 24 females). The 3D-ASL cerebral perfusion imaging was performed on the two groups of patients using different post label delay (PLD) (1525 ms, 2525 ms). The cerebral blood flow (CBF) values of bilateral frontal lobe, temporal lobe, temporal parietal junction, parietal lobe, and hippocampus were analyzed under different PLDs in the two groups. The two sets of MoCA scale scores were compared. The receiver operating characteristic curve (ROC) of CBF of VCI patients was drawn, and the area under curve (AUC), specificity and sensitivity under different PLDs was compared.
Results: There was no statistical significance between the two groups in terms of sex, average age, hypertension, diabetes, coronary heart disease, smoking history, and drinking history (P>0.05). CBF 1525 values and CBF 2525 values in the bilateral frontal lobes, temporal lobes, temporoparietal junction, parietal lobes, and hippocampus were significantly reduced in the VCI group under different PLD (all P<0.05). There was no significant difference in the CBF 1525 value and CBF 2525 value of the bilateral frontal lobe and temporal lobe in the VCI group (all P<0.05). The language, delayed memory, executive ability, attention and calculation ability, naming, abstract thinking, orientation, and total scores of the VCI group were significantly lower than those of the NCF group (all P<0.05). The ROC analysis revealed that the AUC, specificity, and sensitivity of CBF (bilateral frontal, temporal, temporoparietal junction, parietal, and hippocampus) at PLD 1525 ms were lower than those of CBF at PLD 2525 ms (P<0.05).
Conclusion: Non-invasive 3D-ASL technology can be used to detect cerebral hemodynamics and predict prognosis in VCI patients. PLD 1525 ms was more sensitive to detect cerebral hypoperfusion. PLD 2525 ms showed a more accurate hypoperfusion range. This guides and adjusts treatment methods.
Keywords: 3D-ASL; cerebral blood flow; hemodynamics; post label delay; prognosis; vascular cognitive impairment.
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