Wang Yue, Liang Huazheng, Luo Yu, Zhou Yuan, Jin Lingjing, Wang Shaoshi, Bi Yong
Department of Neurology, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China.
Department of Neurology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China.
Front Neurol. 2019 Aug 14;10:867. doi: 10.3389/fneur.2019.00867. eCollection 2019.
The present study aimed to examine the prevalence of and risk factors for magnetic resonance (MR) perfusion abnormality in a Chinese population with transient ischemic attack (TIA) and normal diffusion-weighted imaging (DWI) findings. Patients with TIA admitted to our stroke center between January 2015 and October 2017 were recruited to the present study. MRI, including both DWI and perfusion-weighted imaging (PWI), was performed within 7 days of symptom onset. Time to maximum of the residue function (T) maps were evaluated using the RAPID software (Ischemaview USA, Version 4.9) to determine hypoperfusion. Multivariate analysis was used to assess perfusion findings, clinical variables, medical history, cardio-metabolic, and the ABCD2 scores (age, blood pressure, clinical features, symptom duration, and diabetes). Fifty-nine patients met the inclusion criteria. The prevalence of MR perfusion T ≥ 4 s ≥ 0 ml and ≥ 10 mL were 72.9% (43/59) and 42.4% (25/59), respectively. Multivariate analyses revealed that history of hypertension is an independent factor associated with MR perfusion abnormality (T ≥ 4 s ≥ 10 mL) for Chinese patients with TIA ( = 0.033, adjusted OR = 4.11, 95% CI = 1.12-15.11). Proximal artery stenosis (>50%) tended to lead to a larger PW lesion on MRI ( = 0.067, adjusted OR = 3.60, 95% CI = 0.91-14.20). Our results suggest that the prevalence of perfusion abnormality is high as assessed by RAPID using the parametric T ≥ 4 s. History of hypertension is a strong predictor of focal perfusion abnormality as calculated by RAPID on T map of TIA patients with negative DWI findings.
本研究旨在调查在中国短暂性脑缺血发作（TIA）且弥散加权成像（DWI）结果正常的人群中磁共振（MR）灌注异常的患病率及危险因素。2015年1月至2017年10月期间入住我们卒中中心的TIA患者被纳入本研究。在症状发作7天内进行了包括DWI和灌注加权成像（PWI）的MRI检查。使用RAPID软件（美国Ischemaview，版本4.9）评估残差函数最大值时间（T）图，以确定灌注不足。采用多变量分析来评估灌注结果、临床变量、病史、心脏代谢情况以及ABCD2评分（年龄、血压、临床特征、症状持续时间和糖尿病）。59名患者符合纳入标准。MR灌注T≥4秒≥0毫升和≥10毫升的患病率分别为72.9%（43/59）和42.4%（25/59）。多变量分析显示，高血压病史是中国TIA患者MR灌注异常（T≥4秒≥10毫升）的独立相关因素（P=0.033，校正OR=4.11，95%CI=1.12-15.11）。近端动脉狭窄（>50%）倾向于导致MRI上更大的PW病变（P=0.067，校正OR=3.60，95%CI=0.91-14.20）。我们的结果表明，使用参数T≥4秒通过RAPID评估的灌注异常患病率很高。高血压病史是TIA患者DWI结果为阴性时通过RAPID在T图上计算的局灶性灌注异常的有力预测指标。
