高分辨磁共振成像在老年非心源性急性缺血性脑卒中病因分型中的意义  

Significance of HRMRI in subtyping NCAIS in the elderly

作　　者：马丽娜[1] 郑禹樵 尹雪梅 王玉琳[1] 张俊 项宁[1] 栗静媛 秦学慧 Ma Lina;Zheng Yuqiao;Yin Xuemei;Wang Yulin;Zhang Jun;Xiang Ning;Li Jingyuan;Qin Xuehui(Department of Neurology Qinhuangdao First Hospital,Qinhuangdao 066000,Hebei Province China)

机构地区：[1]秦皇岛市第一医院神经内科,066000 [2]秦皇岛市第一医院心内科,066000 [3]秦皇岛市第一医院影像科,066000

出　　处：《中华老年心脑血管病杂志》2023年第12期1260-1263,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨高分辨磁共振成像(HRMRI)对老年非心源性急性缺血性脑卒中(AIS)的诊断价值及意义。方法回顾性分析2022年7月至2023年7月我院收治的老年非心源性AIS患者101例。依据急性脑卒中TOAST分型和中国缺血性脑卒中亚型(CISS)标准对所有受试者病因进行分型。对比两种分类系统在检查前后各病因分型的构成比。结果TOAST分型检查结果显示,有8例小动脉闭塞型、1例其他原因型及5例不明原因型修正为大动脉粥样硬化型(LAA),1例不明原因型修正为小动脉闭塞型,7例LAA及4例不明原因型修正为其他原因型,共修正26例(25.74%)患者的病因诊断,TOAST分型检查前后构成比比较有显著差异(χ^(2)=15.425,P<0.01)。CISS检查结果显示,有10例穿支动脉疾病型、1例其他原因型及4例不明原因型修正为LAA,9例LAA及3例不明原因型修正为其他原因型,共修正27例(26.73%)患者的病因诊断,CISS检查前后构成比比较(χ^(2)=17.300,P<0.01)。结论HRMRI对老年非心源性AIS的精准病因分型具有诊断价值及意义。Objective To investigate the diagnostic value of high-resolution magnetic resonance im-aging(HRMR1)in elderly patients with non-cardioembolic acute ischemic stroke(NCAIS).Meth-ods A retrospective analysis was conducted on 101 elderly NCAIS patients having HRMR1 in our hospital from July 2022 to July 2023.Stroke subtypes were classified according to the Trial of Org 10172 in Acute Stroke Treatment(TOAST)system and the Chinese Ischemic Stroke Sub-classification(CISS)system.The constituent ratio distribution of each subtype classification was compared before and after HRMR1 in both classification systems.Results TOAST system identi-fied 8 cases of small-artery occlusion(SAO),1 case of other determined etiology(SOE),5 cases of undetermined etiology(SUE)and then reclassified as large artery atherosclerosis(LAA),1 case of SUE which was reclassified as SAO,and 7 cases of LAA and 4 cases of SUE being reclas-sified as SOE after HRMR1.In total,the diagnosis of 26 cases(25.74%)was modified.In the CISS system,10 cases of penetrating artery disease(PAD),1 case of other etiologies(OE),and 4 cases of undetermined etiology(UE)were reclassified as LAA.Furthermore,9 cases of LAA and 3 cases of UE were reclassified as OE after HRMR1.1n total,the diagnosis of 27 cases(26.73%)was modified.There were statistical differences in the constituent ratio before and after HRMR1 in both TOAST(χ^(2)=15.425,P<0.01)and C1SS(χ^(2)=17.300,P<0.01)systems.Conclusion HRMR1 is of diagnostic value and significance in accurately diagnosing the etiology of A1S in eld-erly patients without cardioembolic causes.

关 键 词：磁共振成像 卒中 TOAST系统 中国缺血性脑卒中亚型系统 高分辨磁共振成像 

分 类 号：R743.3[医药卫生—神经病学与精神病学]