基于扩散加权成像的急性缺血性脑卒中体积、部位与吞咽困难严重程度之间的关系

Relationship Between DWI-Based Acute Ischemic Stroke Volume, Location and Severity of Dysphagia.

作者信息

Mallio Carlo A, Vertulli Daniele, Di Gennaro Gianfranco, Ascrizzi Maria Teresa, Capone Fioravante, Grattarola Chiara, Luccarelli Vitaliana, Greco Federico, Beomonte Zobel Bruno, Di Lazzaro Vincenzo, Pilato Fabio

机构信息

Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.

Research Unit of Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.

出版信息

Brain Sci. 2024 Nov 26;14(12):1185. doi: 10.3390/brainsci14121185.

DOI:10.3390/brainsci14121185

PMID:39766384

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11675000/

Abstract

BACKGROUND/OBJECTIVES: The impact of stroke location and volume on the development of post-stroke dysphagia is not fully understood. The aim of this study is to evaluate the relationship between acute ischemic lesions and the severity of dysphagia.

METHODS

Brain MRIs were obtained with a 1.5 Tesla MRI system (Magnetom Avanto B13, Siemens, Erlangen, Germany). The brain MRI protocol included axial echo planar diffusion-weighted imaging (DWI). The acute ischemic volume was obtained using DWI by drawing regions of interest (ROIs). The diagnosis and assessment of the severity of dysphagia was carried out by a multidisciplinary team and included the Dysphagia Outcome and Severity Scale (DOSS), the Penetration-Aspiration Scale (PAS), and the Pooling score (P-score). The threshold for statistical significance was set at 5%.

RESULTS

Among all the patients enrolled ( = 64), 28 (43.8%) were males and 36 (56.2%) were females, with a mean age of 78.8 years. Thirty-three (51.6%) of them had mild dysphagia and thirty-one (48.4%) had moderate-severe dysphagia. The total ischemic volume was negatively correlated with the DOSS (r = -0.441, = 0.0003) and positively with the P-score (r = 0.3054, = 0.0328).

CONCLUSIONS

There are significant associations between the severity of dysphagia and the quantitative DWI-based data of the acute ischemic volume and anatomical location.

摘要

背景/目的：卒中部位和体积对卒中后吞咽困难发展的影响尚未完全明确。本研究旨在评估急性缺血性病灶与吞咽困难严重程度之间的关系。

方法

使用1.5特斯拉磁共振成像系统（德国西门子公司埃尔兰根产Magnetom Avanto B13）获取脑部磁共振成像。脑部磁共振成像方案包括轴向回波平面扩散加权成像（DWI）。通过绘制感兴趣区域（ROI），利用DWI获取急性缺血体积。吞咽困难的诊断和严重程度评估由多学科团队进行，包括吞咽困难结果和严重程度量表（DOSS）、渗透-误吸量表（PAS）和积聚评分（P评分）。统计学显著性阈值设定为5%。

结果

在所有纳入的患者（n = 64）中，男性28例（43.8%），女性36例（56.2%），平均年龄78.8岁。其中33例（51.6%）有轻度吞咽困难，31例（48.4%）有中度至重度吞咽困难。总缺血体积与DOSS呈负相关（r = -0.441，P = 0.0003），与P评分呈正相关（r = 0.3054，P = 0.0328）。