Acute diffusion-weighted imaging lesion patterns predict progressive small subcortical infarct in the perforator territory of the middle cerebral artery
Acute diffusion-weighted imaging lesion patterns predict progressive small subcortical infarct in the perforator territory of the middle cerebral artery
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DOI：
10.1111/ijs.12352
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发表时间：
2015-02-01
影响因子：
6.7
通讯作者：
Liu, Xinfeng
中科院分区：
文献类型：
--
作者：
Duan, Zuowei;Sun, Wen;Liu, Xinfeng
背景单一小皮质下梗死（SSSI）通常被认为有一个公平的结果。然而，早期神经功能恶化（END），一个相对不利的临床过程中发生的急性期梗死，目的本研究的目的是探讨在大脑中动脉（MCA）穿支区急性SSSI患者中，弥散加权成像（DWI）检测到的病变类型与END的存在之间的关系。方法前瞻性收集2010年1月至2013年5月在金陵医院收治的312例MCA穿支区急性SSSI患者。急性DWI病变模式根据病变位置与载瘤动脉的关系分为近端SSSI（pSSSI）或远端SSSI（dSSSI）模式。在入院时使用美国国立卫生研究院卒中量表（NIHSS）评估神经功能缺损，并在随后的72小时内每天持续1-3次。结果312例患者中，pSSSI型139例（44.55%），dSSSI型173例（55.45%）;统计学分析表明，小动脉疾病（高血压和脑白质疏松）和动脉粥样硬化（糖尿病和脑动脉粥样硬化）的指标根据病变类型有显著差异（P
BackgroundSingle small subcortical infarct (SSSI) is generally considered to have a fair outcome. However, early neurological deterioration (END), a relatively unfavorable clinical course occurring during the acute phase of infarction, is not uncommon.AimsThe aim of this study was to investigate the relationship between lesion patterns detected by diffusion-weighted imaging (DWI) and the presence of END in patients with acute SSSI in the perforator territory of the middle cerebral artery (MCA).MethodsThree hundred twelve patients with acute SSSI in the perforator territory of MCA were prospectively recruited from Jinling Hospital between January 2010 and May 2013. Acute DWI lesion patterns were classified as proximal SSSI (pSSSI) or distal SSSI (dSSSI) patterns, according to the relationship between lesion location and the parent artery. Neurological deficits were evaluated using the National Institutes of Health Stroke Scale (NIHSS) at admission and continued over the following 72h 1-3 times a day. END was defined as an increase in NIHSS score 2 points during the first 72h after admission.ResultsOf the total 312 patients, the pSSSI pattern was found in 139 (4455%) patients and the dSSSI pattern in 173 (5545%) patients. Statistical analysis suggested that the indicators for small-artery disease (hypertension and leukoaraiosis) and atherosclerosis (diabetes mellitus and cerebral atherosclerosis) significantly differed according to lesion patterns (P