小脑后下动脉角度与心源性脑梗死的相关性

The relationship between the angle of posterior inferior cerebellar artery and cardiogenic cerebral infarction

目的探讨心源性脑梗死与小脑后下动脉(PICA)角度的相关性.方法回顾性分析70例无相关血管狭窄的单侧?PICA区域脑梗死患者的临床资料(男45例,女25例,平均年龄62.5±13.6岁),根据ASCOD表型分类系统,确定心源性卒中的分类,并测量椎动脉和近端PICA的角度.结果多变量logistic回归分析(校正年龄、性别、高血压、高脂血症、糖尿病及卒中史)显示PICA角度与心源性脑梗死的风险独立相关(OR=1.216,95%CI=1.065~1.431).ROC曲线分析使用Youden指数的最佳截断值为88°,在心源性脑梗死患者中,82.4%的患者PICA>88°.结论PICA角度是无相关动脉狭窄单侧PICA区域心源性脑梗死的独立预测因子,提示PICA角度>88°可能是确定卒中亚型的新的影像标记物.

Objective To investigate the association between cardiogenic cerebral infarction and posterior inferior cerebellar artery(PICA)angle.Methods The clinical data of 70 patients with unilateral PICA cerebral infarction without associated vascular stenosis(45 males and 25 females,mean age 62.513.6 years)were retrospectively analyzed.Cardioembolic stroke was determined according to the ASCOD phenotypic classification system.The angle between the vertebral artery and the proximal PICA were measured.Results After adjusting for age,gender,hypertension,hyperlipidemia,diabetes and stroke history,multivariate logistic regression analysis showed that the PICA angle was independently associated with the risk of cardiac embolism cerebral infarction(OR=1.216,95%CI=1.065~1.431).The optimal cut-off value using the Youden index was 88°.In cases with cardiogenic occlusion cerebral infarction,82.4% of patients had a PICA angle of more than 88°.Conclusions The PICA angle is an independent predictor of cardiogenic cerebral infarction in the unilateral PICA region with no associated arterial stenosis,suggesting that a PICA angle greater than 88°may be a new imaging marker for determining stroke subtypes.