Perfusion Deficits in Different Mechanisms of Two Subtypes of Acute Stroke with Diffusion MRI Confirmation.

IF 2 4区医学 Q3 CLINICAL NEUROLOGY

Current neurovascular research Pub Date : 2023-01-01 DOI:10.2174/1567202620666221230141102

Cuiting Zhu, Wei Qin, Wenli Hu

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引用次数: 2

Abstract

Background: Branch atheromatous disease (BAD) and lacunar infract (LI) are the different mechanisms of subtypes of acute stroke. We aimed to investigate perfusion deficits and clinical characteristics of the different mechanisms of two subtypes of acute stroke.

Materials and methods: Five hundred and ninety-nine CTP examinations were retrospectively reviewed between January and December 2021 in patients with acute stroke symptoms with CTP within 12 hours and MRI within 7 days of symptom onset. Based on diffusion MRI, the patients were assigned to one of two subtypes: BAD and LI. Lesion volumes were measured on NCCT, CTA, CBV, CBF, MTT, and TTP maps by region-of-interest analysis and were confirmed by follow-up MRI.

Results: One hundred thirty-three patients met the inclusion criteria (26.3% female). The BAD group was present in 104 of 133 (78.2%), and the LI group 29 of 133 (21.8%). Based on CT perfusion, 42 of 78 (53.8%) BAD group and 5 of 18 (27.8%) LI group had perfusion deficits in the supratentorial region. BAD had a higher proportion of abnormal perfusion than LI patients, with a significant difference (P < 0.05). The sensitivity of CTP ranged from 21.4% (CBV) to 90.5% (TTP); specificity ranged from 97.2% (TTP) to 100% (CBV, CBF, and MTT) in BAD patients.

Conclusion: CTP has high specificity in identifying BAD. Compromised perfusion deficits are more presented in BAD patients compared with LI. CT perfusion imaging may be useful for determining the clinical significance of perfusion abnormalities in BAD occurrence.

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两种亚型急性脑卒中不同机制的灌注缺陷与弥散MRI证实。

背景:分支动脉粥样硬化病(BAD)和腔隙性梗死(LI)是急性脑卒中亚型的不同机制。我们旨在探讨两种亚型急性脑卒中不同机制的灌注缺陷和临床特征。材料和方法:回顾性回顾了2021年1月至12月期间599例急性卒中症状患者的CTP检查，这些患者在症状出现后12小时内伴有CTP，并在症状出现后7天内进行MRI检查。根据弥散MRI，将患者分为两种亚型:BAD和LI。通过感兴趣区域分析，在NCCT、CTA、CBV、CBF、MTT和TTP图上测量病变体积，并通过随访MRI确认。结果:133例患者符合纳入标准，其中女性占26.3%。133例中BAD组104例(78.2%)，LI组29例(21.8%)。CT灌注显示，78例BAD组42例(53.8%)，18例LI组5例(27.8%)幕上区出现灌注缺损。BAD组异常灌注比例高于LI组，差异有统计学意义(P < 0.05)。CTP的灵敏度为21.4% (CBV) ~ 90.5% (TTP);BAD患者的特异性从97.2% (TTP)到100% (CBV、CBF和MTT)。结论:CTP对BAD有较高的特异性。与LI患者相比，BAD患者更容易出现灌注缺陷。CT灌注成像可能有助于确定BAD发生时灌注异常的临床意义。

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

Current neurovascular research 医学-临床神经学

CiteScore

3.80

自引率

9.50%

发文量

审稿时长

3 months

期刊介绍： Current Neurovascular Research provides a cross platform for the publication of scientifically rigorous research that addresses disease mechanisms of both neuronal and vascular origins in neuroscience. The journal serves as an international forum publishing novel and original work as well as timely neuroscience research articles, full-length/mini reviews in the disciplines of cell developmental disorders, plasticity, and degeneration that bridges the gap between basic science research and clinical discovery. Current Neurovascular Research emphasizes the elucidation of disease mechanisms, both cellular and molecular, which can impact the development of unique therapeutic strategies for neuronal and vascular disorders.