Evaluation of mean diffusion and kurtosis MRI mismatch in subacute ischemic stroke: Comparison with NIHSS score
Evaluation of mean diffusion and kurtosis MRI mismatch in subacute ischemic stroke: Comparison with NIHSS score
复制标题
亚急性缺血性脑卒中平均弥散度和峰度 MRI 不匹配的评估：与 NIHSS 评分的比较
DOI：
10.1016/j.brainres.2016.05.020
复制
发表时间：
2016-08-01
期刊：
影响因子：
2.9
通讯作者：
Wu, Ren-hua
中科院分区：
文献类型：
--
作者：
Guo, Yue-lin;Zhang, Zhong-ping;Wu, Ren-hua
神经恶化(ND)是缺血性卒中后的一种毁灭性的并发症。本研究旨在利用弥散峰度成像(DKI)确定有ND和无ND的亚急性缺血性卒中患者的病变特征的差异，并根据美国国立卫生研究院卒中评分(NIHSS)确定可能导致ND的责任病变。根据NIHSS评分和病变个数将79例亚急性脑梗塞患者分为ND(-)组和ND(+)组。ND(+)组平均弥散(MD)损害明显大于峰度(MK)平均缺失(P<；0.05)，而ND(-)组差异无统计学意义(P>；0.05)。随着时间的推移，病变中的MD和MK恢复到正常水平；然而，ND(+)组的恢复趋势明显慢于ND(-)组。两组之间的差异仅在MK方面有显著差异(p<；0.05)。此外，ND(-)组的多发梗死灶表现出良好的一致性，而ND(+)组的多发性梗死灶则不均匀。据我们所知，这是第一个研究表明，在亚急性缺血性卒中中，多个缺血病变在MK上的显著MD/MK错配和异质性可能代表着与ND密切相关的缺血病变或急性再梗塞的新的扩张。(C)2016爱思唯尔B.V.保留所有权利。
Neurological deterioration (ND) is a devastating complication following ischemic stroke. This study aimed to identify the differences in lesion characteristics in subacute ischemic stroke patients with and without ND using diffusional kurtosis imaging (DKI), as well as to confirm the responsible lesions that may lead to ND, as assessed by the National Institutes of Health Stroke Scale (NIHSS) score. Seventy-nine patients with subacute cerebral infarction were allocated to the ND (-) and ND (+) groups according to the NIHSS score and lesion number. The mean diffusion (MD) lesions were significantly larger than the mean kurtosis (MK) deficits in the ND (+) group (P < 0.05); however, there was no significant difference in the ND (-) group (P> 0.05). The MD and MK in the lesion recovered to normal levels over time; however, the recovery trends in the ND (+) group were substantially slower than the ND (-) group. The differences between the two groups were only significant regarding the MK (p < 0.05). Furthermore, multiple infarction lesions exhibited good consistency in the ND (-) group, but were non -homogeneous in the ND (+) group. To the best of our knowledge, this is the first study to demonstrate that a significant MD/MK mismatch and heterogeneity of multiple ischemic lesions on MK in subacute ischemic stroke may represent a new expansion of an ischemic lesion or acute reinfarction, which is closely related to ND. (C) 2016 Elsevier B.V. All rights reserved.