Department of Neurological Sciences, Rush University Medical Center, 1725 West Harrison Street, POB 1106, Chicago, IL 60126, USA.
Department of Radiological Sciences, University of Oklahoma Health Sciences Center, 940 NE 13th Street, Suite 3G3210, Oklahoma City, OK 73104, USA.
J Neurol Sci. 2021 Jun 15;425:117434. doi: 10.1016/j.jns.2021.117434. Epub 2021 Apr 3.
Diffusion weighted imaging (DWI) lesions are common after spontaneous intracerebral hemorrhage (sICH). However, their timing relative to a patient's admission to the hospital is unknown. The purpose of this study is to estimate the timing of new DWI lesions after admission for acute sICH.
Select patients enrolled in a single center prospective study examining the prevalence DWI lesions in acute primary sICH received two MRI scans of the brain after admission. The presence of a new DWI lesion between MRI scans was defined as a new DWI event. A lognormal parametric model was used to estimate the median time (50% percentile) to develop a new DWI lesion.
Among the 121 participants enrolled in the study, 63 (52%) had two brain MRIs. The median time from admission to 1st MRI was 1 day (IQR 1.2, range 0.1-8.4). The median time between the 2 MRI scans was 2.1 (IQR 2.9, range 0.02-17.4) days. 30.2% (n = 19) of participants developed a new DWI lesion between MRI scans. The estimated median time from 1st MRI to new DWI event was 6.3 days (95% CI, 4.1 to 9.6).
Accounting for time from admission to 1st MRI, we found that 50% of new DWI lesions occurred by 7.3 days after sICH admission. Pathophysiologic changes in sICH during this time frame need to be studied in order to elucidate a mechanism for DWI lesions.
自发性脑出血(sICH)后弥散加权成像(DWI)病灶很常见。然而,它们相对于患者入院的时间尚不清楚。本研究的目的是估计急性 sICH 患者入院后新发 DWI 病灶的时间。
选择参加一项单中心前瞻性研究的患者,该研究检查急性原发性 sICH 患者 DWI 病灶的患病率,这些患者在入院后接受了两次脑部 MRI 扫描。两次 MRI 扫描之间出现新的 DWI 病灶定义为新发 DWI 事件。使用对数正态参数模型估计出现新 DWI 病灶的中位时间(50%分位数)。
在这项研究中,共有 121 名患者入组,其中 63 名(52%)患者进行了两次脑部 MRI 检查。从入院到第一次 MRI 的中位时间为 1 天(IQR 1.2,范围 0.1-8.4)。两次 MRI 扫描之间的中位时间为 2.1 天(IQR 2.9,范围 0.02-17.4)。30.2%(n=19)的患者在 MRI 扫描之间出现新的 DWI 病灶。从第一次 MRI 到新 DWI 事件的估计中位时间为 6.3 天(95%CI,4.1 至 9.6)。
考虑到从入院到第一次 MRI 的时间,我们发现 50%的新发 DWI 病灶发生在 sICH 入院后 7.3 天内。需要研究 sICH 在此时间框架内的病理生理变化,以阐明 DWI 病灶的机制。