3.0T磁共振T2 FLAIR高信号血管征与复发性缺血性脑卒中的相关性研究

Correlation between hyperintense vessel sign on T2 FLAIR and recurrent ischemic stroke on 3.0T MRI

目的:探讨3.0T磁共振的液体衰减反转恢复成像序列(fluid attenuated inversion recovery,FLAIR)的高信号血管征(hyperintense vessel sign,HVS)与复发性缺血性脑卒中的相关性。方法:选取常熟市第一人民医院神经内科2019年1—12月符合入选标准的缺血性脑卒中患者508例,收集其临床资料及危险因素(包括性别、年龄、卒中家族史、血压、血脂、血糖、BMI等)。所有患者均采用急性卒中Org 10172治疗试验(Trial of Org 10172 in Acute Stroke Treatment,TOAST)分型,均完善头颅MRI、磁共振血管成像(magnetic resonance angiography,MRA)、FLAIR检查;根据是否为初发卒中,分为初发组(n=367)和非初发组(n=141),比较两组患者危险因素、TOAST分型、HVS发生率等。结果:非初发组年龄、高血压、糖尿病、吸烟、糖化血红蛋白(glycosylated hemoglobin,HbA1c)水平、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)水平、TOAST分型、卒中家族史较初发组明显升高(P<0.05);非初发组HVS发生率高于初发组(P<0.05)。多因素回归分析显示,年龄、高血压、HbA1c水平、LDL-C水平、TOAST分型、HVS发生率与缺血性脑卒中复发相关。结论:HbA1c、LDL-C、年龄、高血压、TOAST分型、HVS可能是缺血性脑卒中复发的独立危险因素;HVS可能有助于预测缺血性脑卒中患者的预后。

Objective:Objective to investigate the correlation between hyperintense vessel sign(HVS)in 3.0T MR fluid attenuated inversion recovery(FLAIR)imaging and recurrent ischemic stroke.Methods:508 patients with ischemic stroke who met the inclusion criteria in Neurology of the First People′s Hospital of Changshu from January to December 2019 were selected to collect their clinical data and risk factors(including gender,age,family history of stroke,blood pressure,blood lipids,blood glucose,BMI,etc.).All patients were classified by Trial of Org 10172 in Acute Stroke Treatment(TOAST),who were examined by cranial MRI,magnetic resonance angiography(MRA)and FLAIR.The patients were divided into primary stroke group(n=367)and non primary stroke group(n=141)according to whether primary stroke.The risk factors,TOAST classification and incidence of HVS were compared between the two groups.Results:The age,hypertension,diabetes,smoking,glycosylated hemoglobin(HbA1c)level,low density lipoprotein cholesterol(LDL-C)level,TOAST classification and family history of stroke in non primary stroke group were significantly higher than those in primary stroke group(P<0.05).The incidence of HVS in non primary stroke group was higher than that in primary stroke group(P<0.05).Multivariate regression analysis showed that age,hypertension,HbA1c level,LDL-C level,TOAST classification,incidence of HVS were associated with the recurrence of ischemic stroke.Conclusion:HbA1c,LDL-C,age,hypertension,TOAST classification and HVS may be independent risk factors for recurrence of ischemic stroke;HVS may be helpful to predict the prognosis of patients with ischemic stroke.