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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Magnetic resonance angiography-diffusion mismatch reflects diffusion-perfusion mismatch in patients with hyperacute cerebral infarction
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Magnetic resonance angiography-diffusion mismatch reflects diffusion-perfusion mismatch in patients with hyperacute cerebral infarction

机译：磁共振血管造影-扩散不匹配反映了超急性脑梗死患者的扩散-灌注不匹配

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Background: We evaluated whether clinical-diffusion mismatch (CDM) or magnetic resonance angiography (MRA)-diffusion mismatch (MDM) is useful in detecting diffusion-perfusion mismatch (DPM) in hyperacute cerebral infarction within 3 hours after stroke onset. Methods: Among patients with cerebral infarction who arrived within 3 hours after stroke onset at our hospital between May 2007 and December 2010, we included 21 patients (16 men and 5 women; mean age 70 ± 7.8 years) with cerebral infarction of the anterior circulation, and in whom magnetic resonance imaging (diffusion-weighted imaging)/MRA and computed tomograpic perfusion of the head were performed at the time of arrival. DPM-positive status was defined as a difference between DWI abnormal signal area and mean transit time prolongation area (≥20% on visual assessment). CDM-positive status was defined as a National Institute of Health Stroke Scale score ≥8 and DWI-Alberta Stroke Program Early CT Score (ASPECTS) ≥8. MDM-positive status was defined as a major artery lesion and DWI-ASPECTS ≥6. Results: Ten of 21 patients had DPM. In all DPM-positive patients, MRA revealed a major artery lesion. Of the 10 DPM-positive patients, 6 were CDM-positive. CDM detected DPM with a sensitivity of 60% and a specificity of 64%. The positive likelihood ratio was 1.65. Of the 10 DPM-positive patients, all were MDM-positive. MDM detected DPM with a sensitivity of 100% and a specificity of 82%. The positive likelihood ratio was 5.5. Conclusions: In hyperacute cerebral infarction within 3 hours after onset, MDM, as compared with CDM, was able to detect DPM with higher sensitivity and specificity. This suggests that MDM is more reflective of DPM.
机译：背景：我们评估了中风发作后3小时内，临床扩散性失配（CDM）或磁共振血管造影（MRA）扩散性失配（MDM）是否可用于检测超急性脑梗死的扩散-灌注失配（DPM）。方法：在2007年5月至2010年12月于我院中风发作后3小时内到达的脑梗死患者中，我们纳入了21例前循环脑梗死患者（男16例，女5例;平均年龄70±7.8岁）。 ，并在到达时进行了磁共振成像（弥散加权成像）/ MRA和计算出的头部层析成像。 DPM阳性状态定义为DWI异常信号区域与平均通过时间延长区域之间的差异（在视觉评估中≥20％）。 CDM阳性状态定义为美国国立卫生研究院卒中量表评分≥8，DWI-阿尔伯塔省卒中计划早期CT评分（ASPECTS）≥8。 MDM阳性状态定义为主要动脉病变且DWI-ASPECTS≥6。结果：21名患者中有10名患有DPM。在所有DPM阳性患者中，MRA均显示出大动​​脉病变。在10例DPM阳性患者中，有6例CDM阳性。 CDM检测DPM的敏感性为60％，特异性为64％。正似然比为1.65。在10例DPM阳性患者中，所有患者均为MDM阳性。 MDM检测到DPM的敏感性为100％，特异性为82％。正似然比为5.5。结论：在发病后3小时内的超急性脑梗死中，与CDM相比，MDM能够以更高的灵敏度和特异性检测DPM。这表明MDM更能反映DPM。

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