大脑中动脉血栓的磁敏感加权成像图谱可预测预后。
Middle cerebral artery thrombus susceptibility-weighted imaging mapping predicts prognosis.
作者信息
Zheng Mei-Zhu, Yang Qing-Yuan, Lu Xiu-Di, Hu Si-Le, Chai Chao, Shen Wen, Chang Bin-Ge, Wang Zhi-Yun, Xia Shuang
机构信息
Radiological Department, Third Central Hospital of Tianjin, Tianjin Key Laboratory of Artificial Cell, Artificial Cell Engineering Technology Research Center of Public Health Ministry, Tianjin 300170, China.
Radiological Department, Tianjin Haihe Hospital, Tianjin 300222, China.
出版信息
Quant Imaging Med Surg. 2019 Sep;9(9):1556-1565. doi: 10.21037/qims.2019.08.17.
BACKGROUND
Susceptibility weighted imaging and mapping (SWIM) of magnetic resonance imaging (MRI) is used to evaluate cerebral arterial thrombosis. The aim of this research was to assess susceptibility, length, and clot burden score (CBS) of thrombus in the middle cerebral artery (MCA) and their relationship with cerebral infarction and early clinical prognosis in patients with acute or subacute cerebral infarction.
METHODS
In total, 56 patients with acute or subacute cerebral infarction (with the time from onset to admission less than 72 h) and only unilateral MCA occlusion were included in the current study. All the patients had the corresponding susceptibility vessel sign (SVS) on susceptibility-weighted imaging (SWI). Parameters including susceptibility, length, and CBS of thrombus were obtained from SWI and SWIM. The differences in susceptibility of different portions of the thrombus were compared with each other by one-way ANOVA test. The relationship between susceptibility and stroke onset time was further analyzed by Spearman correlation analysis, in addition to the relationships between susceptibility, length, CBS, diffusion-weighted imaging-Alberta stroke program early CT score (DWI-ASPECTS), and admission and discharge National Institutes of Health Stroke Scale (NIHSS).
RESULTS
The susceptibility among different portions and different segments of thrombus showed no statistical difference. The susceptibility and length were weakly yet negatively correlated with DWI-ASPECTS (r=-0.382, -0.457; P=0.004, 0.000). The susceptibility was weakly yet positively correlated with admission NIHSS and discharged NIHSS (r=0.403, 0.430; P=0.002, 0.001). CBS was weakly yet positively correlated with DWI-ASPECTS (r=0.349; P=0.008) and weakly yet negatively correlated with admission and discharged NIHSS (r=-0.375, -0.335; P=0.004, 0.012).
CONCLUSIONS
The susceptibility remained consistent regardless of location, length, and onset time, which indicates that the thrombus composition was similar when detected on SWI less than 72 h from the onset. Susceptibility and CBS may help to predict clinical severity and short-term clinical prognosis to some extent.
背景
磁共振成像（MRI）的 susceptibility weighted imaging and mapping（SWIM）用于评估脑动脉血栓形成。本研究的目的是评估大脑中动脉（MCA）血栓的敏感性、长度和血栓负荷评分（CBS），以及它们与急性或亚急性脑梗死患者脑梗死和早期临床预后的关系。
方法
本研究共纳入56例急性或亚急性脑梗死患者（发病至入院时间小于72小时）且仅单侧MCA闭塞。所有患者在 susceptibility-weighted imaging（SWI）上均有相应的敏感性血管征（SVS）。从SWI和SWIM获取血栓的敏感性、长度和CBS等参数。采用单因素方差分析比较血栓不同部位的敏感性差异。除了分析敏感性、长度、CBS、扩散加权成像-阿尔伯塔卒中项目早期CT评分（DWI-ASPECTS）与入院和出院时美国国立卫生研究院卒中量表（NIHSS）之间的关系外，还通过Spearman相关分析进一步分析敏感性与卒中发病时间的关系。
结果
血栓不同部位和不同节段的敏感性无统计学差异。敏感性和长度与DWI-ASPECTS呈弱负相关（r = -0.382，-0.457；P = 0.004，0.000）。敏感性与入院NIHSS和出院NIHSS呈弱正相关（r = 0.403，0.430；P = 0.002，0.001）。CBS与DWI-ASPECTS呈弱正相关（r = 0.349；P = 0.008），与入院和出院NIHSS呈弱负相关（r = -0.375，-0.335；P = 0.004，0.012）。
结论
无论血栓的位置、长度和发病时间如何，其敏感性保持一致，这表明在发病后72小时内通过SWI检测时血栓成分相似。敏感性和CBS在一定程度上可能有助于预测临床严重程度和短期临床预后。
Zotero 插件