Huang Y, Mei W L, Liu H Q, Li Y L, Chen Z Z, Li D D, Zhang J W
Department of Neurology, People's Hospital of Zhengzhou University, Zhengzhou 450003, China.
Zhonghua Yi Xue Za Zhi. 2017 Jan 3;97(1):7-11. doi: 10.3760/cma.j.issn.0376-2491.2017.01.003.
To analysis the value of susceptibility vessel sign (SVS) in susceptibility weighted imaging (SWI) in detecting thrombogenesis in middle cerebral artery (MCA) and its association with clinical prognosis. From December 2014 to December 2015 in People's Hospital of Zhengzhou University, we retrospectively examined clinical, imaging and experimental datafrom 104 consecutive patients with acute ischemic strokeand compared the consistency of detecting thrombus between SWI and magnetic resonance angiography (MRA) using Kappa analysis. Clot Burden Score (CBS) was used to analysis extent and scope of thrombus. The association between CBS and clinical prognosiswere analyzed by Spearman rank correlation. Mean age was 60 years old of the 104 patients with acute cerebral infarction and female accounted for 32%. There were 39 patients (37.5%) with SVS positive in SWI and 32 patients (30.8%) with both SVS positive and MRA occlusion or severe stenosis. The consistency in predicting arterial thrombosis of occlusion or severe stenosis between MRA and SVS in SWI was statistically significant (Kappa=0.502, <0.001). There were 6 cases with SVS positive and none stenosis in MRA, and all the clots in this 6 case were located in distal artery. CBS was significantly associated with 3-month outcome (Spearman ρ =-0.472; <0.001). SWI is superior to MRA for the detection of intracranial distal thrombus in patients with acute ischemic stroke of the MCA territory. Higher clot burden(lower CBS) could be an important clinical tool to estimate poor outcome in patients with acutecerebral infarction.
分析磁敏感加权成像（SWI）中的磁敏感血管征（SVS）在检测大脑中动脉（MCA）血栓形成中的价值及其与临床预后的关系。2014年12月至2015年12月，在郑州大学人民医院，我们回顾性分析了104例急性缺血性脑卒中患者的临床、影像和实验数据，并使用Kappa分析比较了SWI和磁共振血管造影（MRA）检测血栓的一致性。采用血栓负荷评分（CBS）分析血栓的范围和程度。通过Spearman等级相关性分析CBS与临床预后的关系。104例急性脑梗死患者的平均年龄为60岁，女性占32%。SWI中39例（37.5%）SVS阳性，32例（30.8%）SVS阳性且MRA闭塞或严重狭窄。MRA与SWI中SVS在预测动脉闭塞或严重狭窄性血栓形成方面的一致性具有统计学意义（Kappa=0.502，P<0.001）。有6例SVS阳性而MRA无狭窄，这6例中的所有血栓均位于远端动脉。CBS与3个月预后显著相关（Spearman ρ=-0.472；P<0.001）。对于MCA区域急性缺血性脑卒中患者，SWI在检测颅内远端血栓方面优于MRA。较高的血栓负荷（较低的CBS）可能是评估急性脑梗死患者不良预后的重要临床指标。
