Application of susceptibility-weighted imaging in staging diagnosis of ischemic cerebral infarction and its prognostic value

Objective This study aims to evaluate the imaging characteristics of susceptibility-weighted imaging (SWI) in patients with ischemic cerebral infarction at different stages and to investigate its association with neurological outcomes and prognostic value. Methods A total of 165 patients with ischemic cerebral infarction were enrolled, including 97 in the acute phase and 68 in the recovery phase. All patients underwent 3.0 Tesla (3.0T) SWI examination. The presence of prominent vessel sign (PVS), susceptibility vessel sign (SVS), hemorrhagic transformation (HI), and cerebral microbleeds (CMBs) was recorded. National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), and Barthel Index, were compared between groups. Spearman correlation analysis and receiver operating characteristic (ROC) curve analysis were used to assess the relationship between SWI indicators and prognosis. Results The recovery-phase group showed significantly higher rates of PVS positivity and HI positivity, as well as a greater number of CMBs. Patients in the acute-phase group had higher NIHSS scores at both admission and discharge, higher 3-month mRS scores, and lower Barthel Index scores. Correlation analysis revealed that PVS, SVS, HI, and CMBs were positively correlated with NIHSS and mRS scores but negatively correlated with the Barthel Index, with CMBs showing the strongest association ( r = −0.855, p 0.001). ROC curve analysis indicated that CMBs had the best predictive performance for poor prognosis, outperforming PVS, SVS, and, HI. Conclusion SWI can reveal imaging differences across different stages of ischemic cerebral infarction and its indicators are closely associated with neurological dysfunction.