Diffusion-Weighted Imaging Combined with Cervical Vascular Ultrasound in the Elderly Patients with Multiple Cerebral Infarction

Abstract

Objective. This study is aimed at evaluating the diagnostic value of diffusion-weighted imaging combined with cervical vascular ultrasound in the elderly patients with multiple cerebral infarctions and at demonstrating whether the diagnostic value is affected by the history of diabetes. Methods. From January 2020 to November 2021, the case data of 30 elderly patients with multiple cerebral infarction diagnosed in our hospital were included. Diffusion-weighted magnetic resonance imaging (DWI) and cervical vascular ultrasound (CAU) were performed, respectively. The diagnosis rates of the simple diffusion-weighted imaging group, the simple cervical vascular ultrasound group, and the diffusion-weighted imaging combined with cervical vascular ultrasound group were compared. Results. The median onset time of 30 patients was 26.5 (4.75, 43.0) hours. There were 10 hyperacute patients and 20 acute patients. The proportion of diagnosable patients in the diffusion-weighted imaging group was 83.8% (25/30), which was lower than the proportion of diagnosable patients in the diffusion-weighted imaging combined with cervical vascular ultrasound group, which was 90% (27/30). The difference was statistically significant ( ${\chi }^2=16.667$ ; $P<0.001$ ). The ratio of diagnosable patients in the cervical vascular ultrasound group alone was 66.7% (20/30), which was lower than 90% (27/30) in the diffusion-weighted imaging combined with cervical vascular ultrasound group. The difference was statistically significant ( ${\chi }^2=6.7$ ; $P=0.010$ ). In the hyperacute phase, the proportion of diagnosable patients in the diffusion-weighted imaging combined with cervical vascular ultrasound group was higher than that in the diffusion-weighted imaging group alone ( ${\chi }^2=5.833$ ; $P=0.016$ ) and the cervical vascular ultrasound group alone ( ${\chi }^2=2.500$ ; $P=0.004$ ). In the acute phase, the proportion of diagnosable patients in the diffusion-weighted imaging combined with cervical vascular ultrasound group was also higher those that in the diffusion-weighted imaging group alone ( ${\chi }^2=9.474$ ; $P=0.002$ ) and the cervical vascular ultrasound group alone ( ${\chi }^2=3.158$ ; $P=0.006$ ). The diagnostic accuracy of diffusion-weighted imaging combined with cervical vascular ultrasound was not significantly different between patients with history of diabetes and without history of diabetes ( ${\chi }^2=1.014$ ; $P=0.314$ ) Conclusion. The combined application of diffusion-weighted imaging and cervical vascular ultrasound has important value in improving the diagnosis rate of multiple cerebral infarction in the elderly, regardless of diabetes history, and it is worthy of clinical application.