短暂性脑缺血发作的疾病特点对磁共振弥散加权成像结果的影响

Effect of transient ischemic attack characteristics on diffusion-weighted imaging

目的探讨短暂性脑缺血发作(transient ischemic attack,TIA)的疾病特点与磁共振弥散加权成像(diffusion-weighted imaging,DWI)的关系。方法选择2017年1月~2019年12月首都医科大学附属北京世纪坛医院神经内科住院的老年TIA患者219例,根据DWI检查结果分为急性脑梗死组74例和对照组145例。比较2组的疾病特点及实验室数据。结果急性脑梗死组高血压、脑卒中/TIA史、TIA次数、持续时间、ABCD2和ABCD3-I评分、红细胞计数以及空腹血糖水平明显高于对照组,差异有统计学意义(P<0.05,P<0.01)。Pearson相关分析显示,随着TIA次数和持续时间增加急性脑梗死发生增多(P<0.01)。二元logistic回归分析显示,高血压(OR=2.853,95%CI:1.351~6.027,P=0.006)、脑卒中/TIA史(OR=5.030,95%CI:1.505~16.815,P=0.009)、TIA持续时间(OR=1.034,95%CI:1.019~1.050,P=0.000)、次数(OR=1.926,95%CI:1.316~2.817,P=0.001)对TIA后DWI阳性具有预测意义。结论高血压、脑卒中史、TIA次数和持续时间影响DWI的结果,而且TIA次数越多、持续时间越长,DWI上更容易出现缺血病灶。

Objective To study the relationship between the characteristics of transient ischemic attack(TIA)and diffusion-weighted imaging(DWI).Methods Two hundred and ninteen TIA patients admitted to our hospital from January 2017 to December 2019 were divided into acute cerebral infarction(ACI)group(n=74)and ACI-free group(n=145)according to the findings on their DWI.The characteristics of ACI and laboratory testing data were compared between the two groups.Results The history of hypertension and cerebral stroke/TIA,and the duration of TIA were significantly longer,the number of TIA and the RBC count were significantly greater,the ABCD2 and ABCD3-I scores and serum fasting blood glucose level were significantly higher in ACI group than in ACI-free group(P<0.05,P<0.01).Pearson correlation analysis showed the incidence of ACI increased with the number and duration of TIA(P<0.01).Binary logistic regression analysis displayed that the history of hypertension,cerebral stroke/TIA,duration and number of TIA could predict the positive DWI after TIA(OR=2.853,95%CI:1.351-6.027,P=0.006;OR=5.030,95%CI:1.505-16.815,P=0.009;OR=1.034,95%CI:1.019-1.050,P=0.000;OR=1.926,95%CI:1.316-2.817,P=0.001).Conclusion History of hypertension and cerebral stroke,number and duration of TIA are the influencing factors of DWI.The greater the number of TIA is,the longer the duration of TIA is,the easier the ischemic lesion occurs on DWI.