随访扩散加权图像揭示了疑似过渡性缺血性发作中缺血性病变的延迟出现
Hiroyuki Kida1, Kenichiro Sakai1, Takeo Sato1
1Department of Neurology, Jikei University School of Medicine, Tokyo, JPN.
Cureus
|November 29, 2023
概括
过渡性缺血性中风 (TIA) 患者没有初始扩散权重图像 (DWI) 病变,但在随访DWI时有延迟的病变,称为延迟指定的缺血性中风 (DSIS),经历了较差的结果. 高龄和大血管封闭 (LVO) 是DSIS的独立预测因素.
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:
- 在初始扩散权重成像 (DWI) 显示没有急性缺血性病变时,暂时性缺血性攻击 (TIA) 诊断可能具有挑战性.
- 一小部分TIA患者在随访DWI时表现出延迟的病变出现,需要进一步调查.
研究的目的:
- 根据临床特征和结果,区分延迟指定的缺血性中风 (DSIS) 和精确查的TIA (WSTIA).
- 在疑似TIA患者中确定延迟DWI病变出现的预测因子.
主要方法:
- 追溯分析144名疑似TIA的患者进行了连续DWIMRI.
- 患者被分为DSIS (第二次DWI损伤) 和WSTIA (两次DWI都没有损伤).
- 临床背景,国家卫生研究院中风量表 (NIHSS) 评分和修改的兰金量表 (mRS) 三个月后的结果的比较.
主要成果:
- DSIS患者年龄较大,入院NIHSS得分较高,大血管封闭 (LVO) 的患病率更高,症状持续时间更长.
- 在DSIS组中,有利的三个月的mRS得分 (0-1) 不太常见.
- 高龄和LVO是DSIS的独立预测因素.
结论:
- 连续DWIMRI对于诊断TIA患者的缺血性中风至关重要,TIA患者最初的结果是负面的,特别是那些患有高级年龄或LVO等危险因素的患者.
- 确定DSIS有助于风险分层和对TIA患者的适当管理.
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