利用标准护理卒中成像评估肌肉疏松症的可行性和有效性。

IF 2.2 3区 医学 Q3 CLINICAL NEUROLOGY
Katrina Knight, Niall Finnegan, Aisling Rafter, Daniel Forbes, Douglas Black, Terry Quinn
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引用次数: 0

摘要

导言:肌肉疏松症是一种与年龄有关的综合症,表现为肌肉松弛、肌力减退和功能丧失。在急性脑卒中后进行功能评估具有挑战性。最近有人描述了使用标准颈部 CT 成像对骨骼肌肉进行放射学评估的方法。我们试图确定其可行性,并探索 CT 定义的肌肉疏松症、经过验证的虚弱和功能指数与 18 个月后的预后之间的关联。方法 我们使用了一项前瞻性队列研究的成像和临床数据。收集的虚弱和功能指数包括美国国立卫生研究院卒中量表、Barthel日常生活活动指数、Fried虚弱表型、Lawton日常生活活动工具量表、非残疾虚弱者(FiND)问卷和卒中前改良Rankin量表。使用 ImageJ 软件对急性中风诊断时获得的颈部 CT 血管造影的单张横向切片进行骨骼肌面积评估,并计算骨骼肌指数(SMI)。采用二元逻辑回归法评估肌肉疏松症、虚弱和功能指数与 18 个月后死亡或残疾之间的关系。结果 在 86 名可能符合条件的患者中,73 人被纳入研究。所有纳入患者的 CT 扫描结果均可进行骨骼肌分析。SMI与功能或虚弱指数并无密切联系。SMI本身与18个月后的死亡或残疾无关。在缩写 FiND 评分中加入 SMI 似乎加强了其关联性和预后价值。结论 本研究证明了在急性脑卒中患者中进行基于 CT 的骨骼肌评估的初步可行性。与功能性和虚弱度指标以及短期预后(包括日常生活活动能力)之间的关系需要在更大的外部队列中进行探索和验证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Feasibility and Validity of Sarcopenia Assessment Using Standard of Care Stroke Imaging.

Introduction: Sarcopenia, an age-related syndrome defined by low muscularity, loss of muscle strength, and performance, is increasingly recognized as a potential contributor to disability following acute stroke. It is challenging to assess functionally in the acute post-stroke setting. Radiological assessment of skeletal musculature using standard of care CT neck imaging has recently been described. We sought to determine its feasibility and explore associations between CT-defined sarcopenia, validated frailty and functional indices and outcome at 18 months.

Methods: Imaging and clinical data from a prospective cohort study were used. Frailty and functional indices were collected, including the NIH Stroke Scale, Barthel Index for Activities of Daily Living, Fried frailty phenotype, Lawton Instrumental Activities of Daily Living (IADL) Scale, the Frail Non-Disabled (FiND) Questionnaire and pre-stroke modified Rankin Scale. Single transverse slices of neck CT angiograms obtained at the time of acute stroke diagnosis were assessed for skeletal muscle area using ImageJ software; a skeletal muscle index (SMI) was calculated. The relationship between sarcopenia, frailty and functional indices and death or disability at 18 months was assessed using binary logistic regression.

Results: Of 86 potentially eligible patients, 73 were included. It was possible to perform skeletal muscle analysis on the CT scans of all included patients. SMI and functional or frailty indices were not closely correlated. SMI alone was independently related to death or disability at 18 months. The addition of SMI to the abbreviated FiND score appeared to strengthen its associations and prognostic value.

Conclusion: This study demonstrates initial feasibility of CT-based skeletal muscle assessment in patients with acute stroke. The relationships with functional and frailty measures as well as short term outcomes including the ability to execute activities of daily living are required to be explored and validated in a larger, external cohort.

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来源期刊
Cerebrovascular Diseases
Cerebrovascular Diseases 医学-临床神经学
CiteScore
4.50
自引率
0.00%
发文量
90
审稿时长
1 months
期刊介绍: A rapidly-growing field, stroke and cerebrovascular research is unique in that it involves a variety of specialties such as neurology, internal medicine, surgery, radiology, epidemiology, cardiology, hematology, psychology and rehabilitation. ''Cerebrovascular Diseases'' is an international forum which meets the growing need for sophisticated, up-to-date scientific information on clinical data, diagnostic testing, and therapeutic issues, dealing with all aspects of stroke and cerebrovascular diseases. It contains original contributions, reviews of selected topics and clinical investigative studies, recent meeting reports and work-in-progress as well as discussions on controversial issues. All aspects related to clinical advances are considered, while purely experimental work appears if directly relevant to clinical issues.
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