Lamy C, Oppenheim C, Calvet D, Domigo V, Naggara O, Méder J L, Mas J L
Service de Neurologie, de l' Hôpital Sainte-Anne, 1, rue Cabanis, 75674 Paris Cedex 14, France.
Eur Radiol. 2006 May;16(5):1090-5. doi: 10.1007/s00330-005-0049-5. Epub 2006 Jan 5.
The purpose of this study was to determine frequency and the characteristics of diffusion-weighted imaging (DWI) abnormalities in patients with transient ischaemic attack (TIA). We analysed data of 98 consecutive patients (mean age: 60.6+/-15.4 years, 56 men) admitted between January 2003 and April 2004 for TIA. Age, gender, symptom type and duration, delay from onset to magnetic resonance imaging (MRI), probable or possible TIA and cause of TIA were compared in patients with (DWI+) and without (DWI-) lesions on DWI. Volume and apparent diffusion coefficient (ADC) values of DWI lesions were computed. DWI revealed ischaemic lesions in 34 patients (34.7%). Lesions were small (mean volume: 1.9 cm(3)+/-3.3), and ADC was moderately decreased (mean ADC ratio: 79.5%). The diagnosis of TIA was considered as probable in all DWI+ patients. A multiple logistic regression model demonstrated that TIA duration greater than or equal to 60 min (OR, 7.6; 95% CI, 2.3-25.7), aphasia (OR, 9.2; 95% CI, 2.7-31.4) and motor deficit (OR, 5.1; 95% CI, 1.5-17.8) were independent predictors of DWI lesions. Prolonged TIA duration, aphasia and motor deficits are associated with DWI lesions. More than half of TIA patients with symptoms lasting more than 60 min have DWI lesions.
本研究的目的是确定短暂性脑缺血发作(TIA)患者弥散加权成像(DWI)异常的频率及特征。我们分析了2003年1月至2004年4月期间因TIA入院的98例连续患者(平均年龄:60.6±15.4岁,56例男性)的数据。比较了DWI上有(DWI+)和无(DWI-)病变患者的年龄、性别、症状类型和持续时间、从发病到磁共振成像(MRI)的延迟时间、可能或疑似的TIA以及TIA的病因。计算了DWI病变的体积和表观扩散系数(ADC)值。DWI显示34例患者(34.7%)存在缺血性病变。病变较小(平均体积:1.9 cm³±3.3),ADC中度降低(平均ADC比率:79.5%)。所有DWI+患者的TIA诊断均被视为可能。多因素logistic回归模型显示,TIA持续时间大于或等于60分钟(OR,7.6;95%CI,2.3 - 25.7)、失语(OR,9.2;95%CI,2.7 - 31.4)和运动功能缺损(OR,5.1;95%CI,1.5 - 17.8)是DWI病变的独立预测因素。TIA持续时间延长、失语和运动功能缺损与DWI病变相关。症状持续超过60分钟的TIA患者中,超过一半有DWI病变。