Dynamic Changes of Asymmetric Cortical Veins Relate to Neurologic Prognosis in Acute Ischemic Stroke
Dynamic Changes of Asymmetric Cortical Veins Relate to Neurologic Prognosis in Acute Ischemic Stroke
复制标题
不对称皮质静脉的动态变化与急性缺血性中风的神经预后相关
DOI：
10.1148/radiol.2021210201
复制
发表时间：
2021-12-01
期刊：
影响因子：
19.7
通讯作者：
Xia, Shuang
中科院分区：
文献类型：
--
作者：
Lu, Xiudi;Luo, Yu;Xia, Shuang
背景资料：脑氧合与急性缺血性卒中（AIS）的神经功能密切相关，可以使用定量磁敏感图（QSM）从不对称突出皮质静脉（APCV）无创测量。目的：采用QSM脑MRI定量AIS患者的静脉血氧饱和度（SvO（2）），分析其在2周随访时的变化，材料与方法：回顾性研究2016年至2020年连续入选的AIS患者，在发病24 h内和治疗后2周内接受脑部MRI检查，分析SvO（2）对临床预后的影响。使用QSM定量APCV的SvO（2）。采用独立样本t检验比较有无APCV患者的SvO（2）。采用配对样本t检验评估SvO（2）的动态变化。采用Pearson和斯皮尔曼相关分析探讨SvO（2）动态变化与低灌注、美国国立卫生研究院卒中量表（NIHSS）评分变化和90 d改良等级量表（mRS）评分之间的关系。采用独立样本t检验比较不同临床表现和结局亚组之间SvO（2）的动态变化。结果：73例患者中有39例（平均年龄70岁± 10岁[标准差]; 49例男性）在入院时检测到APCV，35例患者在2周随访MRI时消失。平均SvO（2）从35.0%+/-5.8增加到64.5%+/-10.0（P <0.01）。001)39例患者。对于35例APCV消失的患者，SvO2的动态变化与NIHSS评分的变化呈负相关（r = 0.37，R-2 = 0.19，P = 0.03）和90天mRS评分（r = 0.54，R-2 = 0.27，P = 0.001），90天结局良好的亚组（n = 19）中SvO（2）的动态变化大于90天结局较差的亚组（n = 16）（平均值，34.5%+/-5.8 vs 29.7%+/-6.3; 95%CI：0.6，8.9; P = 0.03）.结论：对于在2周随访MRI时皮质静脉不对称突出消失的患者，使用定量磁敏感性标测的脑MRI检测到的不对称皮质静脉的氧饱和度改善与较好的急性缺血性卒中结局相对应。（C）RSNA，2021年
Background: Cerebral oxygenation is closely related to neural function in acute ischemic stroke (AIS) and can be measured noninvasively from asymmetrically prominent cortical veins (APCVs) using quantitative susceptibility mapping (QSM).Purpose: To quantify venous oxygen saturation (SvO(2)) using brain MRI with QSM in patients with AIS, to analyze its change at 2-week follow-up, and to assess the influence of SvO(2) in clinical prognosis.Materials and Methods: Between 2016 and 2020, consecutive patients with AIS who underwent brain MRI within 24 hours from symptom onset and 2 weeks after treatment were retrospectively enrolled. The SvO(2) of APCVs was quantified using QSM. The independent sample t test was used to compare the SvO(2) between patients with and patients without APCVs. The paired sample t test was used to assess the dynamic change in SvO(2). Pearson and Spearman correlation analysis was used to explore the relationship among dynamic change in SvO(2) and hypoperfusion, National Institutes of Health Stroke Scale (NIHSS) score change, and 90-day modified Rank in Scale (mRS) score. The independent sample t test was used to compare the dynamic change in SvO(2) between different clinical prognoses and outcome subgroups.Results: APCVs were detected in 39 of 73 patients (mean age, 70 years +/- 10 [standard deviation]; 49 men) at admission and disappeared in 35 patients at 2-week follow-up MRI. The mean SvO(2) increased from 35.0% +/- 5.8 to 64.5% +/- 10.0 (P..001) in 39 patients. For the 35 patients with APCVs that disappeared, the dynamic change in SvO(2) negatively correlated with change in NIHSS score (r =.0.37, R-2 = 0.19, P =.03) and 90-day mRS score (r =.0.54, R-2 = 0.27, P =.001), and the dynamic change in SvO(2) in the subgroup with good 90-day outcomes (n = 19) was greater than that in the subgroup with poor 90-day outcomes(n = 16) (mean, 34.5% +/- 5.8 vs 29.7% +/- 6.3; 95% CI: 0.6, 8.9; P =.03).Conclusion: Improved oxygen saturation of asymmetric cortical veins detected using brain MRI with quantitative susceptibility mapping corresponded with better acute ischemic stroke outcomes for patients with asymmetrically prominent cortical veins that disappeared at 2-week follow-up MRI. (C)RSNA, 2021