Boutet Claire, Rouffiange-Leclair Laure, Garnier Pierre, Quenet Sara, Delsart Daphné, Varvat Jérôme, Epinat Magali, Schneider Fabien, Antoine Jean-Christophe, Mismetti Patrick, Barral Fabrice-Guy
Department of Radiology, University Hospital of Saint-Etienne, France; Thrombosis Research Group EA 3065, Jean Monnet University, Saint-Etienne, France.
Department of Radiology, University Hospital of Saint-Etienne, France.
Eur J Radiol. 2014 May;83(5):824-8. doi: 10.1016/j.ejrad.2014.01.022. Epub 2014 Feb 7.
To compare magnetic resonance imaging (MRI) brain feature in cryptogenic stroke patients with patent foramen ovale (PFO), cryptogenic stroke patients without PFO and patients with cardioembolic stroke.
The ethics committee required neither institutional review board approval nor informed patient consent for retrospective analyses of the patients' medical records and imaging data. The patients' medical files were retrospectively reviewed in accordance with human subject research protocols. Ninety-two patients under 60 years of age were included: 15 with cardioembolic stroke, 32 with cryptogenic stroke with PFO and 45 with cryptogenic stroke without PFO. Diffusion-weighted imaging of brain MRI was performed by a radiologist blinded to clinical data. Univariate, Fischer's exact test for qualitative data and non-parametric Wilcoxon test for quantitative data were used.
There was no statistically significant difference found between MRI features of patients with PFO and those with cardioembolic stroke (p<.05). Patients without PFO present more corticosubcortical single lesions (p<.05) than patients with PFO. Patients with PFO have more often subcortical single lesions larger than 15mm, involvement of posterior cerebral arterial territory and intracranial occlusion (p<.05) than patients with cryptogenic stroke without PFO.
Our study suggests a cardioembolic mechanism in ischemic stroke with PFO.
比较卵圆孔未闭（PFO）的隐源性卒中患者、无PFO的隐源性卒中患者和心源性栓塞性卒中患者的磁共振成像（MRI）脑特征。
伦理委员会规定，对患者的病历和影像数据进行回顾性分析既无需机构审查委员会批准，也无需患者知情同意。根据人体研究方案对患者的病历进行回顾性审查。纳入92例60岁以下患者：15例心源性栓塞性卒中患者、32例伴有PFO的隐源性卒中患者和45例不伴有PFO的隐源性卒中患者。由对临床数据不知情的放射科医生进行脑MRI的扩散加权成像。使用单变量分析、针对定性数据的费舍尔精确检验和针对定量数据的非参数威尔科克森检验。
PFO患者与心源性栓塞性卒中患者的MRI特征之间未发现统计学显著差异（p<0.05）。无PFO的患者比有PFO的患者出现更多皮质下单一病变（p<0.05）。与无PFO的隐源性卒中患者相比，有PFO患者更常出现大于15mm的皮质下单一病变、大脑后动脉区域受累和颅内闭塞（p<0.05）。
我们的研究提示伴有PFO的缺血性卒中存在心源性栓塞机制。
