临床DWI失配法预测大面积梗死增长概率的可靠性:急性缺血性卒中患者梗死增长百分比与临床DWI失配状态的比较

Nganji Christian, H. Ghanaati, V. Changizi, B. Siroos, Farnoosh Mousavi
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引用次数: 0

摘要

目的:本研究的目的是强调临床DWI不匹配(CDM)在识别大面积梗死患者中的可靠性。方法:我们前瞻性地回顾了21例缺血性卒中患者,他们在卒中症状出现后72小时内接受了DWI成像。图像的描述是由经验丰富的放射科医生制作的。通过手动勾画DWI梗死灶区域来评估病变体积。通过将第二次和第一次梗死体积之差除以第一次梗死体积乘以100来计算梗死生长的百分比。NIHSS评分由经验丰富的神经科医生评估。CDM定义为NIHSS评分≥8分,DWI上初始梗死体积≤25 mL。统计学检验:我们采用非参数检验- kruskal - wallis和卡方检验评估不同CDM组内变量的关系。采用交叉表法检测CDM预测大面积梗死生长的敏感性和特异性。结果:CDM存在于36.8%的患者中,并与梗死生长百分比相关(P < 0.01)。CDM患者的平均百分比增长较高(211.8%),而无CDM患者的平均百分比增长较低(5.7%;B组为10.7%;CDM预测梗死生长的敏感性和特异性分别为77.8%和100%,似然比为15.4 (P = 0.0004)。结论:比较CDM和梗死生长百分比的方法证明CDM的概念可以准确地指示存在大量的半暗区梗死危险组织。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reliability of Clinical DWI Mismatch Approach to Predict Patient With the Probability of Large Infarct Growth: A Comparison of the Percentage of Infarct Growth and Clinical DWI Mismatch Status of the Patients With Acute Ischemic Stroke
Purpose: The purpose of this study is to highlight the reliability of clinical DWI mismatch (CDM) in the identification of patients with large infarct growth. Methods: We prospectively reviewed 21 ischemic stroke patients who underwent DWI imaging within 72 hours from stroke symptoms onset. Description of images was made by experienced radiologists. Lesion volumes were assessed by manually outlining the DWI infarct lesions area. The percentage of infarct growth was calculated by dividing the difference between second and first infarct volume by the first infarct volume times 100. The NIHSS scores were assessed by an experienced neurologist. CDM was defined as NIHSS score ≥8 and initial infarct volume on DWI ≤ 25 mL. Statistical Tests: We assessed the relationships of variables within different groups of CDM using nonparametric tests—Kruskal-Wallis and chi-square test. Sensitivity and specificity of CDM to predict large infarct growth were tested by using crosstabs table. Results: CDM was present in 36.8% of our patients and was associated with the percentage of infarct growth (P < .01). The mean percentage growth was high in patients with CDM (211.8%) while it was low in the group of patients without CDM (5.7%; group B and 10.7%; group C). The sensitivity and specificity of CDM to predict infarct growth was 77.8% vs 100% with a likelihood ratio of 15.4 (P = .0004). Conclusion: The approach of comparing CDM and percentage of infarct growth proved that the concept of CDM can accurately indicate the existence of a large volume of tissue at risk of infarction—penumbra.
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