The presence of multiple microbleeds as a predictor of subsequent cerebral hemorrhage in patients with moyamoya disease
The presence of multiple microbleeds as a predictor of subsequent cerebral hemorrhage in patients with moyamoya disease
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DOI：
10.1227/01.neu.0000311067.41239.e6
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发表时间：
2008-01-01
期刊：
影响因子：
4.8
通讯作者：
Hashimoto, Nobuo
中科院分区：
文献类型：
--
作者：
Kikuta, Ken-Ichiro;Takagi, Yasushi;Hashimoto, Nobuo
目的：探讨烟雾病患者无症状微出血（mbbs）与后续卒中发生的关系。方法：从2003年10月开始，连续50例烟雾病患者加入了一项使用3-T磁共振成像的前瞻性研究。这些患者从最初的磁共振研究开始被跟踪，直到第一次中风或最后的磁共振研究。中位随访期为15个月。患者包括13名男性和37名女性，年龄从9岁到68岁（平均年龄40.5±16.2岁）。结果：虽然在初始磁共振研究中27例患者未发现MBs，但在其余23例患者中共发现66个MBs。11例为单发MB， 12例为多发MB。根据mb的数量将患者分为三组：非mb组、单mb组和多mb组。Kaplan-Meier曲线显示，多mb组发生出血的可能性明显高于非mb组和单mb组（P=0.0380）。在随后的无梗死率方面，三组之间没有显著差异。使用Cox比例风险模型进行的年龄校正分析也显示，多重MBs是一个独立的风险因素（风险比为2.89；95%可信区间为1.001-13.24）。结论：多发MBs可能是烟雾病患者后续出血的预测因子。要确认这些结果，需要对更多的患者进行研究，并进行更长时间的随访。
OBJECTIVE: To examine the relationship between asymptomatic microbleeds (MBs) and the occurrence of subsequent stroke in patients with moyamoya disease.METHODS: Beginning in October 2003, 50 consecutive patients with moyamoya disease were enrolled in a prospective study using 3-T magnetic resonance imaging. These patients were followed from the date of the initial magnetic resonance study until the date of the first subsequent stroke or final magnetic resonance study. The median follow-up period was 15 months. The patients were comprised of 13 men and 37 women ranging in age from 9 to 68 years (mean age, 40.5 +/- 16.2 yr).RESULTS: Although no MBs were found in 27 patients in the initial magnetic resonance study, a total of 66 MBs were found in the remaining 23 patients. Eleven patients had a single MB and 12 had multiple MBs. The patients were divided into three groups according to the number of MBs: a non-MB group, a single-MB group, and a multi-MB group. Kaplan-Meier curves of the three groups showed a significantly higher likelihood of subsequent hemorrhage in the multi-MB group than in either the non-MB or single-MB groups (P=0.0380). No significant differences among the three groups were seen in terms of their subsequent infarction-free ratios. Age-adjusted analysis performed with the Cox proportional hazard model also showed the presence of multiple MBs as an independent risk factor (hazard ratio, 2.89; 95% confidence interval, 1.001-13.24).CONCLUSION: The presence of multiple MBs might be a predictor of subsequent hemorrhage in patients with moyamoya disease. Confirmation of these results will require a study with a larger number of patients and a longer follow-up period.