卵圆孔未闭相关青年卒中患者影像特征分析

Clinical and neuroimaging characterization of young ischemic stroke patients associated with patent foramen ovale

目的 在探讨卵圆孔未闭(PFO)相关青年卒中患者的神经影像特征。方法 收集沧州市中心医院伴PFO的青年卒中患者的临床和影像资料,以不同PFO直径、右向左分流(RLS)分流量、PFO结构分型进行分组,分析患者脑梗死的分布、部位、病灶数量和面积。结果 共收集100例患者,由于PFO有关青年卒中患者多为多发梗死和深部梗死,以后循环更为常见。无过间隔血流的PFO患者更容易同时累及前后循环(P<0.05)。不同PFO直径大小和RLS分流量对患者脑梗死的分布、脑梗死部位及病灶数量均无影响(P>0.05)。此外,伴有PFO的青年卒中患者的脑梗死面积通常<15 mm,尤其在雨帘型PFO患者中比例显著较高(P<0.05)。结论 PFO是导致青年卒中的重要原因之一,其影像学上表现为多发梗死、深部梗死和后循环梗死,PFO解剖特点对脑梗死模式具有重要影响,为进一步探索PFO与青年卒中之间的关系提供了新的线索。

Objective To investigate the neuroimaging features of young ischemic stroke patients with patent foramen ovale(PFO)and,particularly,the differences in stroke patterns associated with different PFO anatomical characteristics.Methods Clinical data,imaging,and related examination data were collected from young ischemic stroke patients who were admitted to Cangzhou Central Hospital with PFO.The patients were categorized into different groups to analyze the distribution,location,number,and size of cerebral infarctions.Grouping variables included PFO diameter,right-to-left shunt(RLS)degree,PFO structural subtypes.Results A total of 100 patients were collected,and the results showed that young ischemic stroke patients with PFO presented with multiple infarctions and deep infarctions on neuroimaging,with a higher prevalence of posterior circulation involvement.Patients without interatrial septal blood flow via PFO were more likely to have concomitant anterior and posterior circulation infarctions(P<0.05).However,different PFO diameters and RLS degrees had no impact on the distribution of cerebral infarctions,infarction locations,or the number of lesions(P>0.05).Furthermore,the cerebral infarction area in young ischemic stroke patients with PFO was typically less than 15 mm,especially in patients with a"curtain"pattern PFO,where this proportion was significantly higher(P<0.05).Conclusion PFO is one of the important causes of young ischemic stroke,with neuroimaging features characterized by multiple infarctions,deep infarctions,and posterior circulation involvement.There is a significant correlation between PFO anatomical characteristics and stroke patterns.This study provides new clues for further exploration of the relationship between PFO and young ischemic stroke.