Yu Jinchao, Wang Liming, Li Zhenzhi, Wang Shanshan, Wang Guangbin
Shandong Medical Imaging Research Institute Affiliated to Shandong University, Jinan, China; Department of Radiology, Weihai Municipal Hospital, Weihai, China.
Department of Radiology, Weihai Municipal Hospital, Weihai, China.
J Stroke Cerebrovasc Dis. 2017 Oct;26(10):2346-2353. doi: 10.1016/j.jstrokecerebrovasdis.2017.05.023. Epub 2017 Jun 21.
The aim of our study was to analyze the related factors of asymmetrical cortical vein sign (ACVS) and asymmetrical medullary vein sign (AMVS) on susceptibility-weighted imaging (SWI) in patients with acute middle cerebral artery (MCA) stroke and whether their presence can be used as an independent predictor for clinical outcome.
According to the presence of ACVS and AMVS on SWI, 124 patients with acute MCA stroke within 3 days were divided into several different groups. In addition, those patients were also divided into good and poor outcome group by using the modified Rankin Scale at 3 months after stroke. We investigated respectively the differences in magnetic resonance imaging findings and the clinical data among those different groups.
The ACVS was demonstrated in 90 of 124 patients. Of the 90 patients, 47 were accompanied with the AMVS. The rest of 34 patients showed no ACVS and AMVS. The infarct size and MCA status showed significant differences among the ACVS+, AMVS+ group; ACVS+, AMVS- group; and ACVS-, AMVS- group (all P < .001). Moreover, the ACVS, AMVS, and MCA occlusion were more common in the poor outcome group (all P< .001). In the multivariate logistic regression, AMVS (P = .027; odds ratio, 2.37; 95% confidence interval, 1.23-8.73) was associated with poor outcome.
The ACVS and AMVS were correlated to the status of MCA steno-occlusion and infarct size, whereas the AMVS was proved to be independently related to the stroke severity and poor outcome rather than the ACVS.
本研究旨在分析急性大脑中动脉（MCA）卒中患者在磁敏感加权成像（SWI）上不对称皮质静脉征（ACVS）和不对称髓质静脉征（AMVS）的相关因素，以及它们的出现是否可作为临床预后的独立预测指标。
根据SWI上ACVS和AMVS的出现情况，将124例发病3天内的急性MCA卒中患者分为不同组。此外，在卒中后3个月使用改良Rankin量表将这些患者分为预后良好组和预后不良组。我们分别研究了不同组之间磁共振成像结果和临床数据的差异。
124例患者中有90例出现ACVS。在这90例患者中，47例伴有AMVS。其余34例患者未出现ACVS和AMVS。ACVS阳性、AMVS阳性组；ACVS阳性、AMVS阴性组；以及ACVS阴性、AMVS阴性组之间的梗死灶大小和MCA状态存在显著差异（均P <.001）。此外，ACVS、AMVS和MCA闭塞在预后不良组中更常见（均P <.001）。在多因素逻辑回归分析中，AMVS（P = 0.027；比值比，2.37；95%置信区间，1.23 - 8.73）与预后不良相关。
ACVS和AMVS与MCA狭窄闭塞状态及梗死灶大小相关，而AMVS被证明与卒中严重程度和预后不良独立相关，而非ACVS。
