Retrospective Cohort Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2021; 9(35): 10828-10837
Published online Dec 16, 2021. doi: 10.12998/wjcc.v9.i35.10828
Application of MAGnetic resonance imaging compilation in acute ischemic stroke
Qi Wang, Gang Wang, Qiang Sun, Di-He Sun
Qi Wang, Gang Wang, Qiang Sun, Di-He Sun, Department of Radiology, The Stroke Hospital of Liaoning Province, Shenyang 110101, Liaoning Province, China
Author contributions: Wang Q and Wang G designed and coordinated the study; Sun Q and Sun HD treated the patients.
Supported by Wu Jieping Medical Foundation, No. 320.6750.2020-11-22.
Institutional review board statement: The study was reviewed and approved for publication by our Institutional Reviewer.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection before study enrollment.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gang Wang, MD, Doctor, Department of Radiology, The Stroke Hospital of Liaoning Province, No. 49 Xuesong Road, Sujiatun District, Shenyang 110101, Liaoning Province, China. 444966958@qq.com
Received: July 23, 2021
Peer-review started: July 23, 2021
First decision: August 19, 2021
Revised: August 31, 2021
Accepted: October 20, 2021
Article in press: October 20, 2021
Published online: December 16, 2021
Processing time: 140 Days and 3.2 Hours
Abstract
BACKGROUND

Synthetic magnetic resonance imaging (MRI) MAGnetic resonance imaging compilation (MAGiC) is a new MRI technology. Conventional T1, T2, T2-fluid-attenuated inversion recovery (FLAIR) contrast images, quantitative images of T1 and T2 mapping, and MAGiC phase sensitive inversion recovery (PSIR) Vessel cerebrovascular images can be obtained simultaneously through post-processing at the same time after completing a scan. In recent years, studies have reported that MAGiC can be applied to patients with acute ischemic stroke. We hypothesized that the synthetic MRI vascular screening scheme can evaluate the degree of cerebral artery stenosis in patients with acute ischemic stroke.

AIM

To explore the application value of vascular images obtained by synthetic MRI in diagnosing acute ischemic stroke.

METHODS

A total of 64 patients with acute ischemic stroke were selected and examined by MRI in the current retrospective cohort study. The scanning sequences included traditional T1, T2, and T2-FLAIR, three-dimensional time-of-flight magnetic resonance angiography (3D TOF MRA), diffusion-weighted imaging (DWI), and synthetic MRI. Conventional contrast images (T1, T2, and T2-FLAIR) and intracranial vessel images (MAGiC PSIR Vessel] were automatically reconstructed using synthetic MRI raw data. The contrast-to-noise ratio (CNR) values of traditional T1, T2, and T2-FLAIR images and MAGiC reconstructed T1, T2, and T2-FLAIR images in DWI diffusion restriction areas were measured and compared. MAGiC PSIR Vessel and TOF MRA images were used to measure and calculate the stenosis degree of bilateral middle cerebral artery stenosis areas. The consistency of MAGiC PSIR Vessel and TOF MRA in displaying the degree of vascular stenosis with computed tomography angiography (CTA) was compared.

RESULTS

Among the 64 patients with acute ischemic stroke, 79 vascular stenosis areas showed that the correlation between MAGiC PSIR Vessel and CTA (r = 0.90, P < 0.01) was higher than that between TOF MRA and CTA (r = 0.84, P < 0.01). With a degree of vascular stenosis > 50% assessed by CTA as a reference, the area under the receiver operating characteristic (ROC) curve of MAGiC PSIR Vessel [area under the curve (AUC) = 0.906, P < 0.01] was higher than that of TOF MRA (AUC = 0.790, P < 0.01). Among the 64 patients with acute ischemic stroke, 39 were scanned for traditional T1, T2, and T2-FLAIR images and MAGiC images simultaneously, and CNR values in DWI diffusion restriction areas were measured, which were: Traditional T2 = 21.2, traditional T1 = -6.7, and traditional T2-FLAIR = 11.9; and MAGiC T2 = 7.1, MAGiC T1 = -3.9, and MAGiC T2-FLAIR = 4.5.

CONCLUSION

The synthetic MRI vascular screening scheme for patients with acute ischemic stroke can accurately evaluate the degree of bilateral middle cerebral artery stenosis, which is of great significance to early thrombolytic interventional therapy and improving patients’ quality of life.

Keywords: Acute ischemic stroke; Magnetic resonance imaging; Magnetic resonance angiography; Computed tomography angiography; Phase sensitive inversion recovery

Core Tip: This study evaluated the application value of vascular images obtained by synthetic magnetic resonance imaging in diagnosing acute ischemic stroke. Synthetic magnetic resonance imaging can obtain vascular images simultaneously as T2, T1, T2-fluid-attenuated inversion recovery and other contrast images. Compared with the results of computed tomography angiography examination, we found that the vascular images can be used to positively evaluate the degree of intracranial bilateral middle cerebral artery stenosis, which is of great significance to early thrombolytic interventional therapy and improving patients’ quality of life.