高分辨磁共振对颅内动脉狭窄缺血性脑卒中患者中国缺血性卒中亚型分型的一致性研究  

The consistency of high-resolution magnetic resonance for ischemic stroke subtyping in intracranial artery stenosis ischemic stroke patients in China

作　　者：魏雪 刘希睿 童林艳[2] 李晋芳[2] 龚思引 WEI Xue;LIU Xirui;TONG Linyan;LI Jinfang;GONG Siyin(The Second Clinical College of Chongqing Medical University,Chongqing 400010,China;Department of Neurology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二临床学院,重庆400010 [2]重庆医科大学附属第二医院神经内科,重庆400010

出　　处：《现代医药卫生》2024年第23期3979-3984,共6页Journal of Modern Medicine & Health

基　　金：重庆市卫生健康委员会医学科研项目(2023WSJK001);重庆市首批公共卫生重点学科(专科)项目。

摘　　要：目的比较不同研究者对高分辨磁共振(HRMR)和非HRMR颅内动脉狭窄缺血性脑卒中(IS)患者中国缺血性卒中亚型(CISS)分型的一致性。方法回顾性分析2022年1-12月重庆医科大学附属第二医院神经内科收治的住院治疗的颅内动脉狭窄IS患者110例,根据纳入/排除标准共纳入97例,其中男70例,女27例;年龄27~95岁;根据是否完善HRMR分为HRMR组41例,非HRMR组56例。由2名研究者独立对2组患者临床及影像学资料进行评估,并进行CISS病因及致病机制分型,采用组内相关系数(ICC)方法比较不同研究者CISS分型及致病机制分型的一致性。结果病因分型方面:HRMR组患者中一致39例,不一致2例,一致性优秀(ICC=0.793,P<0.001);非HRMR组患者中一致45例,不一致11例,一致性中等(ICC=0.692,P<0.001)。颅内大动脉粥样硬化型的致病机制分型方面:38例HRMR组患者中一致31例,不一致7例,一致性优秀(ICC=0.751,P<0.001);33例非HRMR组患者中一致23例,不一致10例,一致性中等(ICC=0.686,P<0.001)。结论HRMR能提高不同研究者颅内动脉狭窄IS患者CISS病因及致病机制分型的一致性。Objective To compare the consistency of Chinese ischemic stroke subtyping(CISS)in ischemic stroke(IS)patients with high-resolution magnetic resonance(HRMR)and non-HRMR intracranial artery stenosis among different investigators.Methods A total of 110 patients with intracranial artery stenosis IS admitted to the Department of Neurology of the Second Affiliated Hospital of Chongqing Medical University for hospitalization from January to December 2022 were retrospectively selected,and a total of 97 cases were included according to the inclusion/exclusion criteria,of which 70 cases were male and 27 cases were female;their ages ranged from 27 to 95 years old;and there were 41 cases in the HRMR group and 56 cases in the non-HRMR group.Clinical and imaging data of patients in the two groups were evaluated independently by two investigators,and CISS etiology and pathogenic mechanism typing was performed,and the intragroup correlation coefficient(ICC)method was used to compare the consistency of CISS typing and pathogenic mechanism typing between different investigators.Results For etiologic typing:there were 39 cases of concordance and 2 cases of discordance in the HRMR group,with excellent concordance(ICC=0.793,P<0.001);and there were 45 cases of concordance and 11 cases of discordance in the non-HRMR group,with moderate concordance(ICC=0.692,P<0.001).Regarding the typing of pathogenic mechanism of intracranial atherosclerotic type of large arteries:there were 31 cases of concordance and 7 cases of discordance among 38 patients in HRMR group,with excellent concordance(ICC=0.751,P<0.001);and there were 23 cases of concordance and 10 cases of discordance among 33 patients in non-HRMR group,with moderate concordance(ICC=0.686,P<0.001).Conclusion HRMR improves consistency in staging the etiology and pathogenic mechanisms of CISS in patients with intracranial arterial stenosis IS from different investigators.

关 键 词：缺血性脑卒中 中国缺血性卒中亚型 颅内动脉狭窄 高分辨磁共振 

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]