磁共振联合ABCD2评分系统对短暂性脑缺血发作预后临床应用价值研究  

Clinical application value of MRI combined with ABCD2 scoring system in TIA prognosis

作　　者：陈娟 蔡勇[2] 陶景山[2] 杜春华 CHEN Juan;CAI Yong;TAO Jing-shan(Department of Encephalopathy with Acupuncture,Yancheng City Traditional Chinese Medicine Hospital,Yancheng 224500,China)

机构地区：[1]盐城市中医院针灸脑病科,江苏盐城224000 [2]盐城市滨海县人民医院神经内科,江苏盐城224500 [3]盐城市第一人民医院介入科,江苏盐城224000

出　　处：《中国医学装备》2021年第12期49-52,共4页China Medical Equipment

基　　金：盐城市医学科技发展计划(YK2018081)“短暂性脑缺血发作脑卒中风险的多模态磁共振联合ABCD2评分系统的预测”。

摘　　要：目的:探讨短暂性脑缺血发作(TIA)应用磁共振联合ABCD2评分系统的预后临床价值,为临床诊断及治疗TIA提供参考。方法:选择医院收治的106例短暂性脑缺血发作患者,按神经功能缺损评分的不同将其分对照组(≥6分)和观察组(<6分),每组53例。发病2 d内分别进行ABCD2评分和磁共振检查,观察并比较患者发病后1 d、7 d、30 d及90 d时的脑血管狭窄程度、脑梗死发生率以及90 d的磁共振与ABCD2评分对TIA预后的预测差异。结果:观察组患者的脑血管轻度狭窄比例高于对照组,中度狭窄、重度狭窄及闭锁比例明显低于对照组,差异有统计学意义(χ^(2)=-27.549,χ^(2)=4.810,χ^(2)=5.736,χ^(2)=6.014;P<0.05);观察组患者ABCD2评分明显低于对照组,差异有统计学意义(t=-18.160,P<0.05);观察组患者脑梗死发生率(1 d、7 d、30 d及90 d)明显低于对照组,差异有统计学意义(χ^(2)=4.867,χ^(2)=3.967,χ^(2)=6.014,χ^(2)=4.711;P<0.05)。磁共振与ABCD2评分预测脑梗的能力结果显示,90 d内发生TIA的风险差异显著。受试者工作特征(ROC)曲线显示,ABCD2评分预测TIA患者的ROC曲线下面积(AUC)为0.728,高于磁共振预测的AUC(0.718)。ABCD2评分低的患者轻度血管狭窄例数高于ABCD2评分高的患者,中度血管狭窄、重度血管狭窄及闭锁例数低于ABCD2评分高的患者,ABCD2评分高的患者在治疗后脑梗死发生率更高。结论:ABCD2评分系统与磁共振对TIA患者的预后均具有评估价值,且ABCD2评分系统对TIA患者预后评估价值高于磁共振。Objective:To explore the clinical value of magnetic resonance imaging(MRI)combined with ABCD2 scoring system in the prognosis of transient ischemic attack(TIA)so as to provide references for clinical diagnosis and treatment of TIA.Methods:106 patients with TIA were selected and were divided into control group(the scores≥6)and observation group(the scores<6)according to neurological impairment score,with 53 cases in each group.ABCD2 score and MRI examination were performed on them within 2 days after they occurred TIA.The degree of cerebrovascular stenosis and the incidence of cerebral infarction of patients at the 1th d,7th d,30th d and 90th d after they occurred TIA were observed and compared,as well as the differences of predictions of MRI and ABCD2 score for TIA prognosis at 90th d.Results:The proportion of mild cerebrovascular stenosis in observation group was significantly higher than that in control group,while the proportions of moderate stenosis,severe stenosis and occlusion in observation group were significantly lower than those in control group(χ^(2)=-27.549,χ^(2)=4.810,χ^(2)=5.736,χ^(2)=6.014,P<0.05),respectively.And the ABCD2 score of observation group was significantly lower than that of control group(t=-18.160,P<0.05).The incidence of cerebral infarction in observation group was significantly lower than that in control group at the 1th day,7th day,30th day and 90th day(χ^(2)=4.867,χ^(2)=3.967,χ^(2)=6.014,χ^(2)=4.711,P<0.05),respectively.The results of the predictive ability of MRI and ABCD2 score for cerebral infarction indicated the difference of the risk of occurring TIA within 90 d was significant.The receiver operating characteristic(ROC)curve showed that the area under curve(AUC)of the ROC curve of ABCD2 score was 0.728 in predicting TIA patients,which was significantly higher than 0.718 of MRI in predicting them.The cases with mild cerebrovascular stenosis in patients with low ABCD2 score were higher than those in patients with high ABCD2 score,and the cases with moderate stenosis,s

关 键 词：短暂性脑缺血发作(TIA) ABCD2评分系统 磁共振 价值评估 

分 类 号：R445.2[医药卫生—影像医学与核医学]