纹状体单一小皮质下梗死的病灶指数预测早期神经恶化。
Lesion Indexes Predict Early Neurologic Deterioration in Lenticulostriate Single Small Subcortical Infarction.
机构信息
From the Department of Neurology (Y.G., K.Z., H.L., C.Z., H.Y., Y.Y., Y.X.), The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
From the Department of Neurology (Y.G., K.Z., H.L., C.Z., H.Y., Y.Y., Y.X.), The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
出版信息
AJNR Am J Neuroradiol. 2024 May 9;45(5):568-573. doi: 10.3174/ajnr.A8176.
BACKGROUND AND PURPOSE
Early neurologic deterioration (END) often occurs during hospitalization in single small subcortical infarction (SSSI). The objective was to identify imaging predictors of END.
MATERIALS AND METHODS
SSSIs in the lenticulostriate artery within 72 hours of stroke onset from January 2015 to June 2021 were consecutively enrolled. The posteriority and laterality indexes were assessed on the second section from the top of the corona radiata section showing the lateral ventricle on DWI. A multivariate logistic analysis was used to explore the predictors of END.
RESULTS
A total of 402 patients were included in this study, among whom 93 (23.1%) experienced END. The optimal cutoff points of the posteriority and laterality indexes for predicting END were given by a receiver operating characteristic curve. A multivariate logistic analysis showed that the posteriority index of ≥0.669 (OR: 2.53; 95% CI: 1.41-4.56; = .002) and the laterality index of ≥0.950 (OR: 2.03; 95% CI: 1.03-4.00; = .042) were independently associated with the risk of END. Accordingly, the SSSIs were further divided into 4 types: anterior lateral type (AL-type), anterior medial type (AM-type), posterior lateral type (PL-type), and posterior medial type (PM-type). After the multivariate analysis, in comparison with the AL-type, the AM-type (OR: 3.26; 95% CI: 1.10-9.65), PL-type (OR: 4.68; 95% CI: 1.41-15.56), and PM-type (OR: 6.77; 95% CI: 2.53-18.04) carried significantly elevated risks of END. The PM-type was associated with the highest risk of END.
CONCLUSIONS
The PM-type was found to be associated with the highest risk of END.
背景与目的
在单发性皮质下小梗死（SSSI）患者住院期间，常出现早期神经功能恶化（END）。本研究旨在确定 END 的影像学预测因素。
材料与方法
连续纳入 2015 年 1 月至 2021 年 6 月发病后 72 小时内出现纹状体动脉区域 SSSI 的患者。在显示侧脑室的冠状辐射段顶部第二层面上评估后位指数和侧位指数。采用多变量逻辑分析探讨 END 的预测因素。
结果
本研究共纳入 402 例患者，其中 93 例（23.1%）发生 END。受试者工作特征曲线为预测 END 的后位指数和侧位指数提供了最佳截断点。多变量逻辑分析显示，后位指数≥0.669（比值比：2.53；95%置信区间：1.41-4.56；=0.002）和侧位指数≥0.950（比值比：2.03；95%置信区间：1.03-4.00；=0.042）与 END 的风险独立相关。据此，进一步将 SSSI 分为 4 种类型：前外侧型（AL 型）、前内侧型（AM 型）、后外侧型（PL 型）和后内侧型（PM 型）。多变量分析后，与 AL 型相比，AM 型（比值比：3.26；95%置信区间：1.10-9.65）、PL 型（比值比：4.68；95%置信区间：1.41-15.56）和 PM 型（比值比：6.77；95%置信区间：2.53-18.04）发生 END 的风险显著升高。PM 型与 END 的发生风险最高相关。
结论
PM 型与 END 的发生风险最高相关。
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