目的 探讨预测症状性动脉粥样 硬化性颅内动脉狭窄(sICAS)患者采用支 架植入术疗效的多模态MRI指标，为此类 患者的早期治疗及治疗方案的确定提供依 据。方法 以就诊于我院的重度sICAS患者 120例为研究对象，随机分为对照组与观 察组各60例。所有入组患者治疗前完善 MRI检查(常规MRI+MRA、PWI、高分辨率 磁共振斑块成像)。对照组给予常规内科 治疗，观察组在常规内科治疗基础上加用 血管内支架成形术。所有患者随访1年。 比较治疗前及随访12个月时两组患者的并 发症发生率、卒中复发率、平均通过时间 (MTT)、脑血容量(CBV)、灌注达峰时间 (TTP)及脑血流量(CBF)，分析影像学各指 标与治疗方案的相关性。结果 与治疗前 相比，两组的MTT显著降低，CBV及CBF明 显升高，TTP明显降低，差异均具有统计 学意义(P<0.05)；与对照组相比，观察组 的MTT显著降低，CBV及CBF明显升高，卒 中复发率明显降低，差异均具有统计学意 义(P<0.05)。结论 血管内支架植入术降 低了卒中复发率，多模态MRI灌注成像的 相关指标可用于评估sICAS支架植入术的 疗效。

Objective Prediction of symptomatic atherosclerotic intracranial arterial stenosis (sICAS) were treated with the efficacy of stent implantation image sensitive index, in order to provide the basis for the determination of such patients, early treatment and treatment scheme. Methods 120 cases of severe sICAS in our hospital were randomly divided into the control group and the observation group, 60 cases in each group. Before treatment, all patients were treated with perfect MRI examination (conventional MRI+MRA, PWI, high resolution magnetic resonance imaging). The control group was given routine Department of internal medicine treatment, and the observation group was treated with endovascular stent assisted angioplasty. All patients were followed up for 1 years. Compared with before treatment and were followed up for 12 months of complications in two groups of patients with occurrence rate, stroke recurrence rate, mean through time (MTT), brain blood volume (CBV) and cerebral blood flow (CBF) and image analysis correlation of each index and treatment options. Results Compared with before treatment, two groups of MTT decreased significantly, CBV and CBF increased significantly compared with statistical significance (P<0.05), compared with the control group, observation group of MTT decreased significantly, CBV and CBF increased significantly, stroke recurrence rate was significantly lower compared with statistical significance (P<0.05). Conclusion Endovascular stent implantation can reduce the recurrence rate of stroke, and multi modality MRI perfusion imaging can be used to evaluate the degree of stenosis of symptomatic atherosclerotic intracranial arteries.