Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan.
Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan.
J Stroke Cerebrovasc Dis. 2019 Dec;28(12):104397. doi: 10.1016/j.jstrokecerebrovasdis.2019.104397. Epub 2019 Sep 30.
Diffusion-weighted image (DWI) of magnetic resonance imaging (MRI) can reveal high signal lesion in up to 50% of transient ischemic attack (TIA) patients. However, it is not well-known which factors determine developing DWI positivity. In order to answer this question, we analyzed factors relevant to DWI positivity in TIA patients.
We had 257 stroke patients at a university emergency/neurology wards. They were 140 men, 117 women, mean age 72 (45-88) years. Among them, 24 (9.3%) had TIA (14 men, 10 women, mean age 71 [58-82] years). All patients underwent a 1.5T MRI. In 24 TIA patients, we investigated the following parameters in relation with stroke maturation: ABCD2 score, smoking habits, blood profile, HbA1C, dyslipidemia, coagulation factors, carotid echography, electrocardiography, cardiac echography, chest X-ray, neurological symptom/signs, imaging, and recurrence of neurological symptom on follow-up.
In 24 TIA patients, 13 (54%) were DWI positive and 11 (46%) were DWI negative. After an extensive analysis, all parameters were not relevant to DWI positivity except for plasma osmolarity, i.e., plasma osmolarity in DWI positive cases (305.3 mOsm/l) is significantly higher than that in DWI negative cases (301.3 mOsm/l) (P = .0064). As for recurrence, 4 of 24 TIA patients recurred. They were 1 (9.0%) of 11 DWI negative cases and 3 (23.1%) of 13 DWI positive cases. Therefore, DWI positive cases recurred more frequently than DWI negative cases did, although it did not reach statistical significance.
TIA with DWI positivity in our institute was 54%, closely associated with initial dehydration and might predict stroke recurrence.
磁共振成像（MRI）的弥散加权成像（DWI）可在高达 50%的短暂性脑缺血发作（TIA）患者中显示高信号病变。然而，哪些因素决定了 DWI 的阳性尚不清楚。为了回答这个问题，我们分析了 TIA 患者中与 DWI 阳性相关的因素。
我们在大学急诊/神经内科病房对 257 例脑卒中患者进行了研究。其中男性 140 例，女性 117 例，平均年龄 72（45-88）岁。其中 24 例（9.3%）为 TIA（男性 14 例，女性 10 例，平均年龄 71[58-82]岁）。所有患者均接受 1.5T MRI 检查。在 24 例 TIA 患者中，我们调查了与中风成熟度相关的以下参数：ABCD2 评分、吸烟习惯、血液状况、HbA1C、血脂异常、凝血因子、颈动脉超声、心电图、心脏超声、胸部 X 线、神经系统症状/体征、影像学和随访中神经系统症状的复发情况。
在 24 例 TIA 患者中，13 例（54%）DWI 阳性，11 例（46%）DWI 阴性。经过广泛分析，除血浆渗透压外，所有参数均与 DWI 阳性无关，即 DWI 阳性病例的血浆渗透压（305.3mOsm/L）明显高于 DWI 阴性病例（301.3mOsm/L）（P=0.0064）。至于复发，24 例 TIA 患者中有 4 例复发。其中，11 例 DWI 阴性患者中有 1 例（9.0%），13 例 DWI 阳性患者中有 3 例（23.1%）。因此，DWI 阳性病例的复发率高于 DWI 阴性病例，但无统计学意义。
本研究中我院 DWI 阳性的 TIA 发生率为 54%，与初发脱水密切相关，可能预测中风复发。
