Clinical diagnosis of cerebral amyloid angiopathy related hemorrhage in China: Simplified Edinburgh criteria and Boston criteria version 2.0.

IF 5.8 3区医学 Q1 CLINICAL NEUROLOGY

European Stroke Journal Pub Date : 2025-01-19 DOI:10.1177/23969873241309513

Mengke Zhang, Ruiwen Che, Xin Liu, Chengbei Hou, Zhongyue Wang, Sen Hu, Shengqi Fu, Yuan Kan, Hailiang Sun, Jianmin Xu, Shiliang Ma, Sijie Li, Changhong Ren, Wenbo Zhao, Milan Jia, Jingang Wang, Chuanjie Wu, Xunming Ji

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引用次数: 0

Abstract

Background: Accurate diagnosis of cerebral amyloid angiopathy (CAA) in surviving patients is indispensable for making treatment decisions and conducting clinical trials. We aimed to evaluate the diagnostic value and clinical utility of the simplified Edinburgh computed tomography (CT) criteria for CAA-related hemorrhage in Chinese patients.

Methods: We analyzed 212 patients with lobar hemorrhage who underwent brain CT and magnetic resonance imaging (MRI) from a multicentre cohort. Using the Boston criteria version 2.0 (v2.0) as the gold standard, we assessed the application value of the simplified Edinburgh CT criteria, and investigated whether the Edinburgh CT criteria predict patient outcomes.

Results: Patients with probable CAA accounted for 36.6% according to the Boston criteria v2.0. The Edinburgh CT criteria indicated an area under the receiver operating characteristic curves (AUC) of 0.735 for the diagnosis of probable CAA, and it performed better when there was a high-risk threshold of CAA in the decision curve analysis. Patients with a high risk of CAA based on the Edinburgh CT criteria had poorer outcomes at 90-day after adjusting for confounding factors (p = 0.034). Finger-like projections in the Edinburgh CT criteria were associated with lobar microbleeds, cortical superficial siderosis, and multispot white matter hyperintensity according to the Boston criteria.

Conclusions: Taking the Boston criteria v2.0 as the gold standard, the Edinburgh CT criteria demonstrated good diagnostic value and predicted outcomes well at 90-day in Chinese patients with lobar hemorrhage. Further studies with larger sample sizes are required to confirm these findings.

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中国脑淀粉样血管病相关出血的临床诊断：简化爱丁堡标准和波士顿标准2.0版

背景：准确诊断存活患者的脑淀粉样血管病（CAA）对于制定治疗决策和开展临床试验是必不可少的。我们的目的是评估简化爱丁堡计算机断层扫描（CT）标准对中国患者caa相关出血的诊断价值和临床应用。方法：我们分析了来自多中心队列的212例接受脑CT和磁共振成像（MRI）检查的大叶出血患者。采用波士顿标准2.0版（v2.0）作为金标准，我们评估了简化的爱丁堡CT标准的应用价值，并研究了爱丁堡CT标准是否能预测患者的预后。结果：根据波士顿标准v2.0，可能为CAA的患者占36.6%。爱丁堡CT诊断标准的受试者工作特征曲线（receiver operating characteristic curves， AUC）下面积为0.735，在决策曲线分析中，当存在CAA的高危阈值时，其诊断效果更好。基于爱丁堡CT标准的CAA高风险患者在校正混杂因素后90天的预后较差（p = 0.034）。根据波士顿标准，爱丁堡CT标准中的手指样突出与大叶微出血、皮质浅表性铁沉着和多斑白质高信号有关。结论：以Boston v2.0标准为金标准，爱丁堡CT标准对中国大叶出血患者具有较好的诊断价值，预测90天预后良好。需要更大样本量的进一步研究来证实这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Stroke Journal Multiple-

CiteScore

7.50

自引率

6.60%

发文量

102

期刊介绍： Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.