Inatomi Y, Kimura K, Yonehara T, Fujioka S, Uchino M
Stroke Center, Saiseikai Kumamoto Hospital, Japan.
Neurology. 2004 Feb 10;62(3):376-80. doi: 10.1212/01.wnl.0000110303.57683.3a.
To determine the clinical characteristics of diffusion-weighted images (DWIs) in patients with TIA.
The authors performed prospectively MRI including DWI in 129 consecutively studied patients with TIA (mean age, 67 years; 68% men) within 14 days after TIA onset. They examined the frequency of TIA-related DWI abnormalities and compared the clinical background of patients with and without DWI abnormalities. Using multivariate statistical methods, the authors investigated the independent factors associated with detection of DWI abnormalities.
Fifty-seven patients with TIA (44%) had DWI abnormalities (positive group), whereas 72 (56%) had no abnormalities (negative group). Prolonged TIA duration (TIA duration > or = 30 minutes), hemiparesis, monoparesis, disturbance of higher brain function, history of either stroke or TIA, diabetes mellitus, and atrial fibrillation were observed more frequently in the positive group than in the negative group. No difference in other symptoms, vascular risk factors, or emboligenic cardiac and arterial disease was observed between the two groups. A multiple logistic regression model demonstrated that prolonged TIA duration (odds ratio [OR], 3.7; 95% CI, 1.3 to 10.8) and disturbance of higher brain function (OR, 10.2; 95% CI, 2.2 to 46.9) are significant and independent factors in correlating with DWI abnormalities.
TIA-related DWI abnormalities are associated with prolonged duration of TIA and disturbance of higher brain function. More sustained and extensive ischemia may contribute to DWI abnormalities in patients with TIA.
确定短暂性脑缺血发作(TIA)患者的弥散加权成像(DWI)的临床特征。
作者前瞻性地对129例连续研究的TIA患者(平均年龄67岁;68%为男性)在TIA发作后14天内进行了包括DWI在内的MRI检查。他们检查了与TIA相关的DWI异常的频率,并比较了有和没有DWI异常的患者的临床背景。作者使用多变量统计方法研究了与DWI异常检测相关的独立因素。
57例TIA患者(44%)有DWI异常(阳性组),而72例(56%)无异常(阴性组)。与阴性组相比,阳性组中TIA持续时间延长(TIA持续时间≥30分钟)、偏瘫、单瘫、高级脑功能障碍、中风或TIA病史、糖尿病和心房颤动更为常见。两组在其他症状、血管危险因素或致栓性心脏和动脉疾病方面未观察到差异。多因素logistic回归模型显示,TIA持续时间延长(比值比[OR],3.7;95%可信区间[CI],1.3至10.8)和高级脑功能障碍(OR,10.2;95%CI,2.2至46.9)是与DWI异常相关的重要独立因素。
与TIA相关的DWI异常与TIA持续时间延长和高级脑功能障碍有关。更持久和广泛的缺血可能导致TIA患者出现DWI异常。