突出的静脉标志与急性缺血性中风后恶性脑有关
Ping Lu1, Lingyun Cui1, Xingquan Zhao1,2,3
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
Heliyon
|October 9, 2023
概括
突出静脉标志 (PVS-SWI) 预测急性缺血性中风患者的大型心脏病发作的恶性脑 (MCE). 这种成像标志物表明MCE风险增加,表明需要对受影响个体进行更密切的监测和干预.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 脑卒中医学 脑卒中医学
背景情况:
- 恶性脑 (MCE) 在急性缺血性中风 (AIS) 中显著增加死亡率和残疾.
- 目前的MCE预测严重依赖于心脏病发作量,早期检测工具有限.
- 在敏感度加权成像 (PVS-SWI) 上突出的静脉标志是严重受损组织输液的潜在标志物.
研究的目的:
- 为了研究PVS-SWI和早期发作的MCE之间的关联,在急性缺血性中风患者由于严重的大动脉狭窄或闭塞 (SLASO).
- 评估PVS-SWI作为MCE和其他不良结果的预测因素,包括神经系统恶化和死亡率.
主要方法:
- 对157名患有SLASO的AIS患者进行了回顾性研究 (2018年6月至2020年6月).
- 用于量化PVS-SWI程度的ASPECTS得分; 4-10的得分定义了一个积极的PVS-SWI群.
- 主要结局:MCE (神经系统恶化,中线偏移>5mm). 二次结果:NIHSS恶化 (≥2分),住院死亡,1年死亡率.
- 进行后勤回归分析以评估相关性.
主要成果:
- 40名患者 (25.5%) 发生了MCE.
- 在患有MCE的患者中,PVS-SWI的患病率显著增加 (75.0%对45.3%;P=0.001).
- 多变量分析显示,PVS-SWI作为MCE的独立预测因子,可用于患有较大心脏病发作的大小的患者 (OR: 4.00,95%CI: 1.54-10.35,p = 0.004).
- PVS-SWI还预测了NIHSS恶化 (≥2) 在患有较小心脏病发作的大小的患者中 (OR: 11.13,95%CI: 2.26-54.89,p = 0.003).
- 在PVS-SWI和死亡率之间没有发现显著的关联.
结论:
- PVS-SWI是一种有价值的成像标志物,用于预测AIS患者患有大心脏病发作的早期MCE.
- 大型心脏病发作患者中PVS-SWI的存在表明MCE的风险增加,可能需要加强监测和治疗干预.
- 在患有较小心脏病发作的患者中,PVS-SWI也可能表明神经系统恶化,但与死亡率无关.
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