Jia Zejin, Song Yangguang, Hu Wenli
Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.
Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.
Neurol Sci. 2020 Jul;41(7):1765-1771. doi: 10.1007/s10072-020-04258-z. Epub 2020 Feb 7.
The clinical characteristics of diffusion-weighted imaging (DWI) abnormalities after transient neurological symptoms are of great significance for the early diagnosis and urgent intervention of transient ischemic attack (TIA). This study was aimed to investigate the clinical characteristics associated with acute DWI lesions in transient neurological symptoms.
We retrospectively recruited 302 patients with transient neurological symptoms. According to DWI findings, they were divided into DWI positive and DWI negative group. The clinical characteristics and the TIA-related scores such as ABCD2, ABCD3, ABCD3I, Dawson score, and the Diagnosis of TIA (DOT) score were compared between the two groups. Logistic regression analysis and receiver operating characteristic curves were used to identify the independent factors and compare the predictive value of different TIA scores for acute DWI lesions.
A total of 302 patients were enrolled in this study. The mean age was 61.8 years, and 67.2% were male. We found 89 (29.5%) patients with DWI positivity. Logistic regression analysis showed the characteristic associated with DWI lesions was dysphasia (OR 2.226, 95% CI 1.220-4.062). The area under the curve for Dawson score and the DOT score was 0.610 (95% CI 0.543-0.678) and 0.625 (95% CI 0.559-0.691), respectively.
We found that DWI lesions were detected in 29.5% of patients with transient neurological symptoms and were associated with dysphasia. Dawson score and DOT score could have a higher predictability of DWI lesions in patients with transient neurological symptoms.
短暂性神经症状后弥散加权成像（DWI）异常的临床特征对短暂性脑缺血发作（TIA）的早期诊断和紧急干预具有重要意义。本研究旨在探讨短暂性神经症状中急性DWI病变相关的临床特征。
我们回顾性招募了302例有短暂性神经症状的患者。根据DWI结果，将他们分为DWI阳性组和DWI阴性组。比较两组的临床特征以及TIA相关评分，如ABCD2、ABCD3、ABCD3I、道森评分和TIA诊断（DOT）评分。采用逻辑回归分析和受试者工作特征曲线来确定独立因素，并比较不同TIA评分对急性DWI病变的预测价值。
本研究共纳入302例患者。平均年龄为61.8岁，男性占67.2%。我们发现89例（29.5%）患者DWI呈阳性。逻辑回归分析显示，与DWI病变相关的特征是言语困难（OR 2.226，95%CI 1.220 - 4.062）。道森评分和DOT评分的曲线下面积分别为0.610（95%CI 0.543 - 0.678）和0.625（95%CI 0.559 - 0.691）。
我们发现29.5%的短暂性神经症状患者存在DWI病变，且与言语困难相关。道森评分和DOT评分对短暂性神经症状患者的DWI病变可能具有较高的预测性。
