Zhou Li, Yang Jie, Zhang Wei, Han Limei, Zhou Shenghai, Zheng Chunyan, Feng Hao, Zhong Jianquan
Department of Radiology, Zigong First People's Hospital, Zigong, Sichuan, China.
Front Neurol. 2024 Dec 16;15:1518911. doi: 10.3389/fneur.2024.1518911. eCollection 2024.
Understanding the microscopic pathophysiological mechanisms underlying acute ischemic stroke (AIS) is vital for facilitating early clinical diagnosis and intervention. In this study, we aimed to quantitatively assess brain iron changes in gray matter (GM) nuclei in patients with AIS via quantitative susceptibility mapping (QSM).
Thirty-four patients with AIS and thirty age-and sex-matched healthy controls (HCs) were included. QSM and conventional magnetic resonance imaging were performed. Intergroup differences in regional susceptibility values were calculated for the bilateral caudate nucleus (CN), globus pallidus (GP), putamen (PUT), red nucleus (RN), substantia nigra (SN), thalamus (THA), and dentate nucleus (DN). A receiver operating characteristic curve was plotted to evaluate the classification and diagnostic performance of susceptibility values in distinguishing patients with AIS from HCs. Multiple linear regression analysis was used to investigate the impact of clinical variables on susceptibility values. Correlation analysis was used to assess the correlation between regional iron variations and clinical scores. A paired t test was used to calculate the differences in susceptibility values between the bilateral hemispheres in the participants.
Compared with the HCs, the patients with AIS had significantly increased susceptibility values in the bilateral CN and PUT ( < 0.05, FDR correction). The highest diagnostic performance was observed in the combination of susceptibility values with differences between groups (AUC = 0.722). Multiple linear regression analysis revealed that increased susceptibility in the right CN was significantly associated with smoking ( < 0.05). The susceptibility values were not significantly correlated with the clinical scores ( > 0.05), but age was positively correlated with the modified Rankin Scale scores at admission ( < 0.05). The susceptibility values of the SN exhibited lateral asymmetry in patients with AIS.
This study revealed increased iron concentrations in the GM nuclei of patients with AIS. Iron deposition in GM nuclei may be a potential biomarker for further understanding the pathophysiological mechanism underlying AIS.
了解急性缺血性卒中（AIS）潜在的微观病理生理机制对于促进早期临床诊断和干预至关重要。在本研究中，我们旨在通过定量磁化率成像（QSM）定量评估AIS患者灰质（GM）核团中的脑铁变化。
纳入34例AIS患者和30例年龄及性别匹配的健康对照（HCs）。进行了QSM和传统磁共振成像检查。计算双侧尾状核（CN）、苍白球（GP）、壳核（PUT）、红核（RN）、黑质（SN）、丘脑（THA）和齿状核（DN）区域磁化率值的组间差异。绘制受试者工作特征曲线以评估磁化率值在区分AIS患者和HCs中的分类及诊断性能。采用多元线性回归分析研究临床变量对磁化率值的影响。采用相关性分析评估区域铁变化与临床评分之间的相关性。采用配对t检验计算参与者双侧半球磁化率值的差异。
与HCs相比，AIS患者双侧CN和PUT的磁化率值显著升高（P<0.05，错误发现率校正）。在磁化率值与组间差异的组合中观察到最高的诊断性能（曲线下面积[AUC]=0.722）。多元线性回归分析显示，右侧CN磁化率增加与吸烟显著相关（P<0.05）。磁化率值与临床评分无显著相关性（P>0.05），但年龄与入院时改良Rankin量表评分呈正相关（P<0.05）。AIS患者SN的磁化率值表现出侧方不对称性。
本研究揭示了AIS患者GM核团中铁浓度升高。GM核团中的铁沉积可能是进一步了解AIS潜在病理生理机制的一个潜在生物标志物。
