Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea.
Seoul National University College of Medicine, Seoul, South Korea.
Sci Rep. 2023 Mar 18;13(1):4511. doi: 10.1038/s41598-023-31727-0.
In single subcortical infarction (SSI), changes in lesion size are a major determinant of early neurological deterioration. We evaluated the association between END and infarct growth velocity (IGV) in patients with SSI. We included consecutive patients with SSI who underwent MRI within 24 h of symptom onset between 2010 and 2020. END was defined as an increase of ≥ 2 in the total National Institutes of Health Stroke Scale (NIHSS) score or ≥ 1 in the motor NIHSS score. IGV was calculated using the following formula: IGV (mL/h) = diffusion-weighted imaging volume (mL)/time to MRI (h). A total of 604 patients with SSI were evaluated. Multivariable logistic regression analysis showed that IGV remained significant after adjusting for confounders (aOR = 1.34, 95% CI 1.12-1.61). In a subgroup analysis based on the type of SSI, only patients with distal SSI showed an association between IGV and END (aOR = 1.64, 95% CI 1.24-2.16). In patients with proximal SSI, IGV did not show any statistical association with END. In conclusion, IGV was positively associated with END in patients with SSI. IGV should be interpreted differently in clinical settings depending on the location of the SSI lesion.
在单一皮质下梗死（SSI）中，病变大小的变化是早期神经功能恶化的主要决定因素。我们评估了 SSI 患者的 END 与梗死生长速度（IGV）之间的关系。我们纳入了 2010 年至 2020 年间连续发生 SSI 并在症状发作后 24 小时内接受 MRI 的患者。END 定义为总 NIHSS 评分增加≥2 或运动 NIHSS 评分增加≥1。IGV 通过以下公式计算：IGV（mL/h）= 弥散加权成像体积（mL）/MRI 时间（h）。共评估了 604 例 SSI 患者。多变量逻辑回归分析表明，在调整混杂因素后，IGV 仍然具有统计学意义（优势比[aOR] = 1.34，95%置信区间[CI] 1.12-1.61）。基于 SSI 类型的亚组分析显示，仅远端 SSI 患者的 IGV 与 END 之间存在关联（aOR = 1.64，95%CI 1.24-2.16）。在近端 SSI 患者中，IGV 与 END 无统计学关联。总之，IGV 与 SSI 患者的 END 呈正相关。根据 SSI 病变的位置，IGV 在临床环境中的解释应该有所不同。
