扩散加权成像阴性的短暂性脑缺血发作患者有再次发生短暂性事件的风险。
Diffusion-weighted imaging-negative patients with transient ischemic attack are at risk of recurrent transient events.
作者信息
Boulanger Jean-Martin, Coutts Shelagh B, Eliasziw Michael, Subramaniam Suresh, Scott James, Demchuk Andrew M
出版信息
Stroke. 2007 Aug;38(8):2367-9. doi: 10.1161/STROKEAHA.106.475541. Epub 2007 Jul 5.
BACKGROUND AND PURPOSE
Among patients presenting with a transient ischemic attack (TIA), some clinical features predispose to recurrent TIA, whereas others predispose to subsequent strokes. We assessed the implication of negative diffusion-weighted imaging on a baseline MRI in predicting subsequent TIA.
METHODS
We prospectively studied patients presenting in the emergency department within 12 hours of a TIA (motor or speech). All patients had a MRI within 24 hours of the index event. The primary outcome was TIA within 1 year of study entry. The 1-year risk of stroke was also evaluated.
RESULTS
A total of 85 patients had a MRI, among which 35 patients (41.2%) had a diffusion-weighted imaging lesion. The mean time from symptom onset to MRI was 12.1 hours. Patients without a diffusion-weighted imaging lesion on baseline MRI were 4.6 times (27.4% versus 5.9%; P<0.05) more likely to have a subsequent TIA at 1 year than patients with a diffusion-weighted imaging lesion, but 4.3 times (2.1% versus 9.1%; P=0.19) less likely to have a subsequent stroke.
CONCLUSIONS
The absence of a diffusion-weighted imaging lesion on the baseline scan predicts recurrent transient events rather than stroke.
背景与目的
在短暂性脑缺血发作（TIA）患者中，一些临床特征易导致TIA复发，而另一些则易引发随后的卒中。我们评估了基线磁共振成像（MRI）上弥散加权成像阴性在预测后续TIA中的意义。
方法
我们前瞻性研究了在TIA（运动或言语）发作12小时内到急诊科就诊的患者。所有患者在索引事件发生后24小时内进行了MRI检查。主要结局是研究入组后1年内发生TIA。还评估了1年内发生卒中的风险。
结果
共有85例患者进行了MRI检查，其中35例患者（41.2%）有弥散加权成像病变。从症状发作到MRI检查的平均时间为12.1小时。基线MRI上无弥散加权成像病变的患者在1年内发生后续TIA的可能性是有弥散加权成像病变患者的4.6倍（27.4%对5.9%；P<0.05），但发生后续卒中的可能性比有弥散加权成像病变患者低4.3倍（2.1%对9.1%；P=0.19）。
结论
基线扫描上无弥散加权成像病变可预测复发性短暂事件而非卒中。
Zotero 插件