From the Department of Radiology (N.V.S., D.M.M.) and Departments of Pediatrics and Pediatric Neurology (T.J.B.), Children's Hospital Colorado, Aurora; and Hemophilia and Thrombosis Center (L.L.P., A.L.H., T.J.B.), Department of Anesthesiology (P.S.H., R.J.T.), and Department Neurology (S.P.), University of Colorado Denver, Aurora.
Stroke. 2017 Aug;48(8):2274-2277. doi: 10.1161/STROKEAHA.117.017922. Epub 2017 Jul 5.
Childhood arterial ischemic stroke is frequently associated with an intracranial arteriopathy that often progresses in the first 3 to 6 months post stroke. We hypothesized that children with enhancing arteriopathies on vessel wall imaging (VWI) would have a higher risk of arteriopathy progression than those without enhancement.
Our institutional radiographic database was searched for cases of childhood stroke with VWI. Inclusion criteria consisted of age ranging from 1 month through 20 years, diagnosis of arterial ischemic stroke, available VWI, and follow-up magnetic resonance angiogram. Imaging was reviewed to systematically describe VWI findings, categorize arteriopathies, steroid therapy, and identify progressive arteriopathies using CACADE definitions.
Sixteen cases of childhood stroke at Children's Hospital Colorado between January 1, 2010 and July 1, 2016 were reviewed. Strong vessel wall enhancement at presentation was associated with progressive arteriopathy in 83% of cases (10/12), when compared with 0% (0/4) without strong enhancement (=0.008).
Our case series demonstrates the potential benefit of VWI in children with stroke because it may identify patients who will have progressive arterial disease.
儿童期动脉缺血性脑卒中常与颅内血管疾病相关，这种血管疾病常在脑卒中后 3 至 6 个月内进展。我们假设在血管壁成像（VWI）上有增强性血管疾病的患儿，其血管疾病进展的风险高于无增强的患儿。
我们对儿童期脑卒中的血管壁成像进行了回顾性研究，研究对象为年龄在 1 个月至 20 岁之间、诊断为动脉缺血性脑卒中、有 VWI 并可进行随访磁共振血管造影的患儿。通过回顾性影像学分析，系统描述 VWI 发现、分类血管疾病、类固醇治疗，并使用 CACADE 定义识别进行性血管疾病。
2010 年 1 月 1 日至 2016 年 7 月 1 日期间，对科罗拉多儿童医院的 16 例儿童脑卒中病例进行了回顾性研究。在有增强性血管疾病的 12 例患儿中，有 83%（10/12）存在进行性血管疾病，而无增强性血管疾病的 4 例患儿中无一例存在进行性血管疾病（0/4，=0.008）。
我们的病例系列研究表明，VWI 对儿童脑卒中可能具有潜在的益处，因为它可以识别出那些将患有进行性动脉疾病的患者。
