Cao Yuze, Zhang Mengyu, Zhou Lixin, Yao Ming, Peng Bin, Zhu Yicheng, Ni Jun, Cui Liying
Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Neuroscience Center, Chinese Academy of Medical Sciences, Beijing, China.
Front Neurol. 2019 Apr 9;10:336. doi: 10.3389/fneur.2019.00336. eCollection 2019.
Lipohyalinosis or atherosclerosis might be responsible for single subcortical infarctions (SSIs); however, ways of differentiating between the two clinically remain uncertain. We aimed to investigate whether consecutive slides on axial view or transversal diameter is more effective to differentiate mechanisms by comparing their relationships with white matter hyperintensities (WMHs). All the participants from the Standard Medical Management in Secondary Prevention of Ischemic stroke in China (SMART) cohort who had SSIs in the lenticulostriate artery territory were included and categorized according to consecutive slides on axial view (≥4 consecutive slices or not) and transversal diameter (≥15 mm or not). The associations between the severity of WMHs and the different categories were analyzed. Among the 3,821 patients of the SMART study, 281 had diffusion-weighted image-proven SSIs in the lenticulostriate artery territory. When classified by consecutive slides on axial view, SSIs on ≥4 slices were significantly associated with the severity of the WMHs, both in deep WMH (DWMH) (odds ratio [OR], 0.32; 95% confidence interval [CI], 0.11-0.97; = 0.04) and periventricular hyperintensity (PVH) (OR, 0.37; 95% CI, 0.17-0.78; = 0.01). No such association was found on the basis of the transversal diameter ( > 0.1). Consecutive slides on axial view (≥4 consecutive slices) might be more effective than transversal diameter to identify the atherosclerotic mechanisms of SSIs in the lenticulostriate artery territory. http://www.clinicaltrials.gov. Unique identifier: NCT00664846.
脂质透明变性或动脉粥样硬化可能是导致单个皮质下梗死（SSIs）的原因；然而，临床上区分两者的方法仍不明确。我们旨在通过比较轴向连续切片或横向直径与白质高信号（WMHs）的关系，研究哪种方法在区分梗死机制方面更有效。纳入中国缺血性卒中二级预防标准药物治疗（SMART）队列中所有在豆纹动脉区域发生SSIs的参与者，并根据轴向连续切片（≥4个连续切片与否）和横向直径（≥15 mm与否）进行分类。分析WMHs严重程度与不同分类之间的关联。在SMART研究的3821例患者中，281例在豆纹动脉区域有弥散加权成像证实的SSIs。按轴向连续切片分类时，≥4个切片上的SSIs与深部WMH（DWMH）（优势比[OR]，0.32；95%置信区间[CI]，0.11 - 0.97；P = 0.04）和脑室周围高信号（PVH）（OR，0.37；95% CI，0.17 - 0.78；P = 0.01）的严重程度均显著相关。基于横向直径未发现此类关联（P > 0.1）。轴向连续切片（≥4个连续切片）在识别豆纹动脉区域SSIs的动脉粥样硬化机制方面可能比横向直径更有效。http://www.clinicaltrials.gov。唯一标识符：NCT00664846。
