摘要目的:探讨国产F-STROKE、NeuBrainCARE MRI全自动后处理软件与RAPID软件在输出急性缺血性脑卒中患者梗死核心区体积、最大峰值时间体积、缺血半暗带体积的一致性。方法:该研究为横断面研究。回顾性收集2016年1月至2021年3月同济大学附属上海市第四人民医院（中心1）149例、廊坊长征医院（中心2）120例、梧州市工人医院（中心3）45例急性缺血性脑卒中患者的临床及影像资料。所有患者均接受扩散加权成像（DWI）和动态磁敏感对比-灌注加权成像（DSC-PWI）。采用RAPID、F-STROKE、NeuBrainCARE全自动后处理软件分别对所有急性缺血性脑卒中患者的MRI图像进行全自动后处理分析，并输出梗死核心区（表观扩散系数<620×10 -6 mm 2/s）体积、最大峰值时间（T max>6 s）体积以及缺血半暗带（PWI-DWI不匹配）体积。采用Wilcoxon检验分析F-STROKE、NeuBrainCARE与RAPID软件输出梗死核心区体积、最大峰值时间体积以及缺血半暗带体积的差异。使用Bland-Altman检验和组内相关系数（ ICC）分析F-STROKE、NeuBrainCARE与RAPID软件输出梗死核心区体积、最大峰值时间体积以及缺血半暗带体积的一致性。 结果:F-STROKE与RAPID软件、NeuBrainCARE与RAPID软件输出梗死核心区体积差异均有统计学意义（ Z分别为-10.17、-5.43， P均<0.001）；F-STROKE与RAPID软件、NeuBrainCARE与RAPID软件输出最大峰值时间体积差异均有统计学意义（ Z分别为-3.17、-5.51， P均<0.05）；F-STROKE与RAPID软件输出缺血半暗带体积差异无统计学意义（ Z=-1.43， P=0.153），NeuBrainCARE与RAPID软件输出缺血半暗带体积差异有统计学意义（ Z=-6.45， P<0.05）。Bland-Altman分析显示位于一致性界限范围内的值占所有点值的93.31%以上。 ICC分析显示，F-STROKE、NeuBrainCARE与RAPID软件输出梗死核心区体积、最大峰值时间体积以及缺血半暗带体积的一致性均较高（ ICC>0.6）。 结论:国产F-STROKE、NeuBrainCARE软件与RAPID软件评估急性缺血性脑卒中患者梗死核心区体积、最大峰值时间体积、缺血半暗带体积具有较好的一致性，值得临床推广。

abstractsObjective:To investigate the consistency of domestic F-STROKE, NeuBrainCARE MRI automatic post-processing software and RAPID MRI automatic post-processing software in the output of infarction core area volume, time-to-maximum volume and ischemic penumbra volume in patients with acute ischemic stroke.Methods:The research was cross-sectional. The clinical and imaging data of patients with acute ischemic stroke from January 2016 to March 2021 were retrospectively collected, including 149 cases from Shanghai Fourth People′s Hospital Affiliated to Tongji University (Center 1), 120 cases from Langfang Changzheng Hospital of Hebei Province (Center 2), and 45 cases from Wuzhou Workers Hospital (Center 3). All patients underwent diffusion weighted imaging (DWI) and dynamic magnetic sensitivity contrast-perfusion weighted imaging (DSC-PWI). RAPID, F-STROKE and NeuBrainCARE automatic post-processing software were used to perform automatic post-processing analysis of MRI images of all patients with acute ischemic stroke. The infarct core (apparent diffusion coefficient<620×10 -6 mm 2/s) volume, time-to-maximum (T max>6 s) volume and the ischemic penumbra (PWI-DWI mismatch) volume were output. The Wilcoxon test was used to analyze the difference between F-STROKE, NeuBrainCARE, and RAPID software outputs of infarct core volume, time to maximum peak volume, and ischemic penumbra volume. Bland-Altman and intraclass correlation coefficient ( ICC) were used to analyze the consistency of the infarct core volume, time-to-maximum volume and ischemic penumbra volume output by F-STROKE, NeuBrainCARE and RAPID software. Results:There were statistically significant differences in the core infarct volume between F-STROKE and RAPID software, NeuBrainCARE and RAPID software ( Z=-10.17, -5.43, both P<0.001). There were significant differences in the time-to-maximum volume between F-STROKE and RAPID software, NeuBrainCARE and RAPID software ( Z=-3.17, -5.51, both P<0.05). There was no significant difference in the ischemic penumbra volume between F-STROKE software and RAPID software ( Z=-1.43, P=0.153), and there was significant difference in the ischemic penumbra volume between NeuBrainCARE software and RAPID software ( Z=-6.45, P<0.05). Bland-Altman analysis showed that the values within the limits of agreement accounted for more than 93.31% of all point values. ICC analysis showed high agreement between F-STROKE, NeuBrainCARE, and RAPID software outputs of infarct core volume, time to maximum peak volume, and ischemic penumbra volume ( ICC>0.6). Conclusion:Domestic F-STROKE software, NeuBrainCARE software and RAPID software have good consistency in evaluating the infarct core volume, time-to-maximum volume and ischemic penumbra volume in patients with acute ischemic stroke, which is worthy of clinical promotion.