ABCD2评分法结合颅脑DWI及CTA预测TIA后脑梗死风险 |
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引用本文: | 禹璐,孙凤涛,张厚宁,盛佳曦,宫凤玲.ABCD2评分法结合颅脑DWI及CTA预测TIA后脑梗死风险[J].CT理论与应用研究,2018,27(5):667-674. |
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作者姓名: | 禹璐 孙凤涛 张厚宁 盛佳曦 宫凤玲 |
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作者单位: | 华北理工大学附属医院, 河北 唐山 063000 |
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摘 要: | 目的:在ABCD2评分基础上,评估结合弥散加权成像(DWI)及CTA对短暂性脑缺血(TIA)后短期内发生脑梗死风险的预测价值。方法:连续选取本院2015年1月至2017年6月170例TIA患者(平均年龄62.4岁±5.4岁),全部患者均行DWI及CTA检查,且随访3个月。分别于7天、3个月记录患者ABCD2评分、DWI阳性结果及CTA诊断大动脉粥样硬化(LAA),以评估所有患者短期内发生脑梗死风险的预测价值。结果:170例患者中,68例(40%)患者DWI阳性,43例(25%)诊断LAA。DWI阳性患者中单侧肢体无力(OR=2.3;95% CI,1.1~4.8),TIA症状持续时间≥ 60 min(OR=3.7;95% CI,1.4~9.9),ABCD2> 5(OR=5.4;95% CI,1.5~18.8),LAA(OR=2.7;95% CI,1.3至5.5)。随访期间,7天内发生脑梗死1例,7天至3个月内发生脑梗死6例,ABCD2评分> 5(OR=24.4;95% CI,2.5~238.7),DWI阳性结果(OR=9.8;95% CI,1.1~83.1),LAA(OR=20.4;95% CI,2.4~175.1)。除1例患者外,3个月内发生脑梗死的DWI均为阳性。ABCD2评分、DWI阳性结果及LAA与7天、3个月脑梗死风险的增加是相关联的。结论:在ABCD2评分基础上引入DWI和CTA检查作为辅助,能提高对TIA后发生脑梗死风险的预测能力。
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关 键 词: | 动脉粥样硬化 弥散加权成像 短暂性脑缺血 |
收稿时间: | 2018-06-01 |
The ABCD2 Scoring Combined with DWI and CTA to Predict the Risk of Cerebral Infarction after TIA |
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Institution: | North China University of Science and TechnologyAffiliated Hospital, Tangshan 063000, China |
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Abstract: | Objective: Based on the ABCD2 score, the predictive value of DWI and CTA combined with the risk of cerebral infarction after a short-term TIA was evaluated. Methods: A total of 170 patients with TIA (average age 62.4±5.4 years) were selected consecutively from January 2015 to June 2017 in this hospital. All patients underwent DWI and CTA examinations and were followed up for 3 months. The ABCD2 score, DWI positive results, and CTA diagnosis of large artery atherosclerosis (LAA) were recorded at 7 and 3 months, respectively, to evaluate the predictive value of all patients with a short-term cerebral infarction risk. Results: Of the 170 patients, 68 (40%) were DWI positive and 43 (25%) were diagnosed with LAA. Unilateral limb weakness in DWI-positive patients (OR=2.3; 95% CI, 1.1-4.8), duration of TIA symptoms ≥ 60 minutes (OR=3.7; 95% CI, 1.4-9.9), ABCD2 >5 (OR=5.4); 95% CI, 1.5-18.8), LAA (OR=2.7; 95% CI, 1.3 to 5.5). During follow-up, 1 case of cerebral infarction occurred within 7 days, and 6 cases of cerebral infarction occurred within 7 days to 3 months. ABCD2 score was greater than 5 (OR=24.4; 95% CI, 2.5-238.7), and DWI positive result (OR=9.8; 95% CI, 1.1-83.1), LAA (OR=20.4; 95% CI, 2.4-175.1). With the exception of one patient, patients with cerebral infarction within 3 months were all positive for DWI. The ABCD2 score, DWI positive results, and LAA were associated with an increased risk of cerebral infarction at 7 days and 3 months. Conclusion: The introduction of DWI and CTA examinations based on the ABCD2 score as an aid can improve the ability to predict stroke risk after TIA. |
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