磁共振灌注加权成像联合ABCD2评分对短暂性脑缺血后继发性脑梗死风险的预测价值  

The value of MRI perfusion weighted imaging combined with ABCD2 score in predicting the risk of secondary cerebral infarction after transient cerebral ischemia

作　　者：周科 王力[2] Zhou Ke;Wang Li(Department of Radiology,Zigong Third People′s Hospital,Sichuan 643020,China;不详)

机构地区：[1]四川省自贡市第三人民医院放射科,643020 [2]四川省自贡市第三人民医院神经内科,643020

出　　处：《实用医学影像杂志》2022年第4期345-348,共4页Journal of Practical Medical Imaging

摘　　要：目的 探讨磁共振灌注加权成像(MR-PWI)联合ABCD2评分对短暂性脑缺血(TIA)后继发性脑梗死风险的预测价值。方法 收集本院2018年1月至2020年12月收治的105例TIA患者的临床资料,该组患者于发病后24 h内行MR-PWI检查及ABCD2评分。随访发病后7 d内出现继发性脑梗死的例数。采用Logistic回归分析法评估ABCD2联合PWI与TIA后继发性脑梗死的相关性,采用ROC曲线评估比较预测价值。结果105例患者中31例7 d内出现继发性脑梗死,发生率为29.5%。ABCD2评分中低危组、中危组和高危组的7 d内脑梗死发生率的差异有统计学意义(P<0.05)。PWI阳性组7 d内脑梗死的发生率高于阴性组,差异有统计学意义(P<0.05)。ABCD2评分联合PWI中低危组、中危组和高危组的7 d内脑梗死发生率的差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,ABCD2评分、PWI(+)、颅内动脉病变史是TIA后7 d脑梗死的独立危险因素(P<0.05)。ROC曲线显示,ABCD2联合PWI预测TIA进展风险的特异度、灵敏度分别为69.8%、86.3%。结论 ABCD2联合PWI能够有效预测TIA后继发性脑梗死的风险,其灵敏度高,且临床可操作性强。Objective To investigate the value of perfusion weighted imaging(PWI)combined with ABCD2score in predicting the risk of secondary cerebral infarction after transient cerebral ischemia(TIA).Methods The clinical data of 105 TIA patients in hospital from January 2018 to December 2020 were collected.MR-PWI and ABCD2 scores were performed within 24 hours after TIA.The number of patients with secondary cerebral infarction within 7 days after onset was followed up.Logistic regression analysis was used to evaluate the correlation between ABCD2 combined with PWI and secondary cerebral infarction after TIA.Results Among 105 patients,31 had secondary cerebral infarction within 7 days,the incidence was 29.5%.There was significant difference in the incidence of cerebral infarction within 7 days among low-risk group,medium risk group and high-risk group according to ABCD2score(P<0.05).The incidence of cerebral infarction within 7 days in PWI positive group was higher than that in negative group(P<0.05).ABCD2 score combined with PWI low-risk group,medium risk group and high-risk group had significant difference in the incidence of cerebral infarction within 7 days(P<0.05).Multivariate logistic regression analysis showed that ABCD2 score,PWI(+),and history of intracranial artery disease were independent risk factors of cerebral infarction 7 days after TIA(P<0.05).ROC curve showed that the specificity and sensitivity of ABCD2 combined with PWI were 69.8%and 86.3%respectively.Conclusion ABCD2 combined with PWI can effectively predict the risk of secondary cerebral infarction after TIA,with high sensitivity and strong clinical operability.

关 键 词：磁共振成像 脑缺血发作 短暂性 脑梗死 ABCD2评分 预测 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]