Voxel-Based Lesion Mapping of Cryptogenic Stroke in Patients with Advanced Cancer: A Detailed Magnetic Resonance Imaging Analysis of Distribution Pattern
Voxel-Based Lesion Mapping of Cryptogenic Stroke in Patients with Advanced Cancer: A Detailed Magnetic Resonance Imaging Analysis of Distribution Pattern
复制标题
晚期癌症患者隐源性中风基于体素的病变绘图：分布模式的详细磁共振成像分析
DOI：
10.1016/j.jstrokecerebrovasdis.2017.02.038
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Kinoshita M
中科院分区：
文献类型：
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作者：
Achiha T;Takagaki M;Oe H;Sakai M;Matsui H;Nakanishi K;Ozaki T;Fujimoto Y;Yoshimine T;Nakanishi K;Kinoshita M
背景缺血性卒中是一种与癌症相关的血栓形成，可使患者的体能状态严重恶化。本调查旨在阐明隐源性卒中病变的特征分布模式（S）使用基于体素的病变映射技术和检查隐源性和常规中风晚期cancer.MethodsData晚期癌症患者急性缺血性卒中的43例患者之间的临床表现的差异进行了回顾性收集。根据ASCO卒中评分，将卒中病因分为隐源性或传统卒中病因。临床资料进行了审查，并进行基于体素的病变映射使用弥散加权成像（DWI）可视化的跨患者的空间分布的lesions.ResultsOf 43例患者，25被归类为具有隐源性中风病因和18被归类为具有传统的中风病因。隐源性卒中病因组患者从卒中发作起的中位生存时间为96天，常规卒中病因组为570天（P= 0.01）。隐源性斯托克卒中患者的D-二聚体显著高于常规卒中患者（P= 0.006）。基于体素的病变标测显示DWI高信号病变在大脑皮质和内部分水岭区域以及小脑上级和小脑后下动脉的血管边界区域聚集在cerebellum.ConclusionsVoxel-based病变标测晚期癌症患者的隐源性卒中显示病变在大脑和小脑的血管边界区域聚集，但在穿通动脉区域没有。
BackgroundIschemic stroke is one form of cancer-associated thrombosis that can greatly worsen a patient's performance status. The present investigation aimed to elucidate the characteristic distribution pattern(s) of cryptogenic stroke lesions using a voxel-based lesion-mapping technique and examine the differences in clinical manifestations between cryptogenic and conventional strokes in patients with advanced cancer.MethodsData from 43 patients with advanced cancer who developed acute ischemic stroke were retrospectively collected. Stroke etiology was grouped into either cryptogenic or conventional stroke etiology according to the ASCO stroke score. Clinical data were reviewed, and voxel-based lesion mapping using diffusion-weighted imaging (DWI) was performed to visualize the cross-patient spatial distribution of the lesions.ResultsOf the 43 patients, 25 were classified as having cryptogenic stroke etiology and 18 were classified as having conventional stroke etiology. Median survival time of patients from stroke onset was 96 days for cryptogenic stroke etiology and 570 days for conventional stroke etiology (P= .01). D-dimer of patients was significantly higher in cryptogenic stoke etiology than in conventional stroke etiology (P= .006). Voxel-based lesion mapping showed that DWI hyperintense lesions accumulated at cortical and internal watershed areas of the cerebrum and at the vascular border zone of the superior cerebellar and posterior inferior cerebellar arteries at the cerebellum.ConclusionsVoxel-based lesion mapping for cryptogenic stroke in patients with advanced cancer showed that lesions accumulated at vascular border zones within the brain both at the cerebrum and at the cerebellum, but not at perforating arterial territories.