与儿科缺血性中风路径一致的神经成像相关的因素
Jillian K Gorski1, Divakar S Mithal2, Michele G Mills2
1Division of Emergency Medicine, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital, Chicago, IL.
The Journal of pediatrics
|January 8, 2024
概括
较年轻和非白人儿童对急性缺血性中风的诊断成像测试较少. 磁共振成像 (MRI) 和血管造影中的这些差异可能表明诊断不足,并突出了改善护理的领域.
科学领域:
- 儿科神经学 儿科神经学
- 诊断成像 诊断成像 诊断成像
- 健康差异 在健康上的差异
背景情况:
- 儿童急性缺血性中风是一种关键的神经紧急情况.
- 及时和准确的诊断严重依赖于先进的神经成像技术,如MRI和血管学.
- 了解诊断测试利用的差异对于公平的儿科中风护理至关重要.
研究的目的:
- 为了确定与MRI和血管造影在患有急性缺血性中风的儿童中使用的人口统计学,临床和治疗相关因素.
- 调查儿童中风诊断工作中的潜在差异.
主要方法:
- 采用来自50多家美国儿童医院的数据进行的横截面研究.
- 包括1601名儿童 (29天至17岁) 住院治疗急性缺血性中风.
- 通用线性混合建模评估了与MRI和血管图获取相关的因素.
主要成果:
- 年龄较小,机械通风和黑人种族与MRI获得率较低有关.
- 患有莫亚莫亚病和状细胞疾病的病史增加了MRI的几率.
- 年龄较小,机械通风,西班牙裔和黑人种族,以及有代谢性疾病或的病史与血管造影的几率较低有关.
结论:
- 在儿童急性缺血性中风中使用MRI和血管造影存在显著差异.
- 较年轻和非白人儿童接受这些诊断测试的可能性较低.
- 研究结果表明,潜在的卫生系统局限性或提供者偏见导致诊断不足,需要量身定制的机构途径.
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