Liu H Q, Liu L, Mei W L, Wang C, Zhang J W, Huang Y
Department of Neurology, Henan Provincial People's Hospital, Zhengzhou 450003, China.
Zhonghua Yi Xue Za Zhi. 2018 Sep 4;98(33):2636-2640. doi: 10.3760/cma.j.issn.0376-2491.2018.33.005.
To explore the neuroimaging characteristics associated with the presence of patent foramen ovale(PFO) for patients with cryptogenic stroke. We retrospectively collected the clinical and imaging data of cryptogenic stroke patients with PFO and without PFO from Henan Province People's Hospital from January 1, 2013 to June 30, 2017. Lesion patterns and pertinent vascular territory were compared between the two groups. Multivariate logistic regression analysis was used to explore the independent predictors for the presence of PFO. A total of 54 cryptogenic stroke patients with PFO and 50 cases without PFO were recruited. Compared with PFO(-) stroke group, more patients in PFO(+ ) stroke group had migraine(=0.036), and patients in PFO(+ ) stroke group had higher Risk of Paradoxical Embolism(RoPE) score(=0.030). The lesion pattern of PFO(+ ) stroke was more frequently observed as multiple lesions in multicirculatory (=0.035), and infarcts were more likely to be distributed in the vertebrobasilar artery territory (=0.041); the most frequently involved vessel was the posterior cerebral artery region (=0.006). More patients with PFO(+ ) stroke had old silent stroke lesion(=0.021). On multivariate analysis, infarction distributed in the posterior cerebral artery region(=4.292, 95% 1.469-12.543, =0.008), silent stroke lesion (=6.688, 95% 1.277-35.029, =0.024), and high RoPE score (=1.393, 95% 1.026-1.893, =0.034) were independent parameters that could predict the presence of PFO. Multiple lesions in multicirculatory and the posterior predominance are neuroimaging characteristics of cryptogenic stroke with PFO. Infarction distributed in the posterior cerebral artery region, silent stroke lesion and high RoPE score are independent predictors of the presence of PFO.
探讨隐源性卒中患者合并卵圆孔未闭（PFO）的神经影像学特征。我们回顾性收集了2013年1月1日至2017年6月30日期间河南省人民医院合并PFO和未合并PFO的隐源性卒中患者的临床和影像学资料。比较两组的病变模式和相关血管区域。采用多因素logistic回归分析探讨PFO存在的独立预测因素。共纳入54例合并PFO的隐源性卒中患者和50例未合并PFO的患者。与PFO（-）卒中组相比，PFO（+）卒中组更多患者有偏头痛（P=0.036），且PFO（+）卒中组患者的反常栓塞风险（RoPE）评分更高（P=0.030）。PFO（+）卒中的病变模式更常表现为多循环中的多发病变（P=0.035），梗死更易分布在椎基底动脉区域（P=0.041）；最常累及的血管区域是大脑后动脉区域（P=0.006）。更多PFO（+）卒中患者有陈旧性无症状卒中病变（P=0.021）。多因素分析显示，分布在大脑后动脉区域的梗死（P=4.292，95%可信区间1.469-12.543，P=0.008）、无症状卒中病变（P=6.688，95%可信区间1.277-35.029，P=0.024）和高RoPE评分（P=1.393，95%可信区间1.026-1.893，P=0.034）是预测PFO存在的独立参数。多循环中的多发病变和后部优势是合并PFO的隐源性卒中的神经影像学特征。分布在大脑后动脉区域的梗死、无症状卒中病变和高RoPE评分是PFO存在的独立预测因素。
