中风患者临床与脑部计算机断层扫描结果的相关性：一项横断面研究。

Correlation between clinical and brain computed tomography findings of stroke patients: A cross-sectional study.

作者信息

Vincent Mboizi, Sereke Senai Goitom, Nassanga Rita, Robert Mukisa, Ameda Faith

机构信息

Department of Radiology and Radiotherapy, College of Health Sciences Makerere University Kampala Uganda.

Department of Medicine Mulago National Referral Hospital Kampala Uganda.

出版信息

Health Sci Rep. 2023 May 3;6(5):e1248. doi: 10.1002/hsr2.1248. eCollection 2023 May.

DOI:10.1002/hsr2.1248

PMID:37152223

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10157266/

Abstract

BACKGROUND AND AIMS

In developing countries, the burden of stroke is growing and causing significant morbidity and disability with high mortality rates. Neuroimaging plays a crucial role in differentiating ischemic stroke from an intracerebral hemorrhage, as well as entities other than stroke. This study sought to determine the correlation between the clinical and brain CT scan findings of stroke patients attending three hospitals in Kampala, Uganda.

METHODS

This was a cross-sectional study of clinically suspected stroke patients who were sent for brain CT scan at three selected hospitals in Kampala, Uganda. All brain CT scans of patients with suspected stroke were evaluated and the Alberta stroke program early CT score (ASPECTS) was used for middle cerebral artery (MCA) strokes. Univariate analysis was used to describe the clinico-demographic and brain CT features of stroke and summarized them as percentages. Bivariate and multivariate analysis were used to determine the adjusted odds ratios as a measure of association with a 95% confidence interval (CI).

RESULTS

Of the 270 study participants, 141 (52.2%) were male. 162 (60%) had CT findings of stroke, and 90 (33.3%) had normal brain CT findings. Eighteen (6.7%) had other CT findings like tumor, dural hemorrhage, epidermoid cyst, and others. Ischemic stroke, hemorrhagic stroke, and subarachnoid hemorrhage accounted for 124 (45.9%), 34 (12.6%), and 4 (1.5%) respectively. Limb weakness (55.2%), headache (41.1%), and loss of consciousness (39.3%) were associated with stroke findings on CT. Among the acute ischemic strokes, 30 (73.2%) had a worse (0-7) ASPECT score. Those aged ≥65 years were associated with a worse ASPECTS [AOR: 22.01, (95% CI: 1.58-306.09) = 0.021].

CONCLUSION

More than a third of patients with a clinical diagnosis of stroke had either no CT features of stroke or had other findings. The most commonly affected vascular territory was left MCA. Old age was strongly associated with having the worst ASPECTS score.

摘要

背景与目的

在发展中国家，中风负担不断加重，导致高发病率、高致残率以及高死亡率。神经影像学在鉴别缺血性中风与脑出血以及中风以外的其他病症方面起着至关重要的作用。本研究旨在确定乌干达坎帕拉三家医院中风患者的临床症状与脑部CT扫描结果之间的相关性。

方法

这是一项针对乌干达坎帕拉三家选定医院中临床疑似中风且被送去做脑部CT扫描患者的横断面研究。对所有疑似中风患者的脑部CT扫描进行评估，并将阿尔伯塔中风项目早期CT评分（ASPECTS）用于大脑中动脉（MCA）中风。单因素分析用于描述中风的临床人口统计学特征和脑部CT特征，并将其总结为百分比。双因素和多因素分析用于确定调整后的优势比，作为关联度的衡量指标，并给出95%置信区间（CI）。

结果

在270名研究参与者中，14（52.2%）为男性。162人（60%）有中风的CT表现，90人（33.3%）脑部CT结果正常。18人（6.7%）有其他CT表现，如肿瘤、硬脑膜出血、表皮样囊肿等。缺血性中风、出血性中风和蛛网膜下腔出血分别占124例（45.9%）、34例（12.6%）和4例（1.5%）。肢体无力（55.2%）、头痛（41.1%）和意识丧失（39.3%）与CT上的中风表现相关。在急性缺血性中风患者中，30例（73.2%）的ASPECT评分较差（0 - 7分）。年龄≥65岁者的ASPECTS评分较差[AOR：22.01，（95%CI：1.58 - 306.09），P = 0.021]。