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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Cerebrovascular Dissemination in Time and Space as a Predictor of Cardioembolism
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Cerebrovascular Dissemination in Time and Space as a Predictor of Cardioembolism

机译：脑血管传播时间和空间作为心脏栓塞的预测因子

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Background: Cardioembolism has tendency to recur and cause lesions in distinct cerebrovascular territories. Using the imaging characteristics of cerebral lesions to determine dissemination in time and space (DTS) is a concept already used in other neurologic conditions; however, it has never been applied as a diagnostic tool in ischemic stroke etiology. Aim: This study aimed to assess DTS as a diagnostic marker of cardioembolism. Methods: We enrolled consecutive patients with acute ischemic stroke of various etiologies admitted in a cerebrovascular disease nursery from a university hospital in a retrospective cohort study. We excluded patients with coexisting etiologies, incomplete study, or without an acute vascular lesion on computed tomography scan. Lacunar infarctions were not considered. Cerebrovascular territory was divided into right anterior, left anterior, and posterior. Localization of the acute vascular lesion(s), existence of previous vascular lesions, and their respective areas were analyzed. The presence of dissemination in time, space, or DTS was determined. Results: We included 661 patients (mean age: 74.05 years (SD: 13.01)). Cardioembolism was the etiology with most DTS (30.47% of cardioembolic strokes); DT occurred more frequently within the atherosclerotic subtype (9.88%); DS was more prevalent within the arterial dissection group (3.33%). There was a statistically significant difference in stroke etiology between patients with DTS and patients without dissemination (P <.001). DTS had 81.67% specificity, 30.47% sensitivity, 66.67% positive predictive value, and 49.40% negative predictive value for the identification of cardioembolism. Conclusion: DTS is a specific diagnostic predictor of cardioembolic stroke and may be helpful in guiding etiologic investigation. (C) 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.
机译：背景：心脏栓塞具有重复和引起不同脑血管领土的病变的趋势。使用脑病变的成像特性来确定时间和空间（DTS）的传播是已经在其他神经系统条件下使用的概念;但是，它从未被应用于缺血性卒中病因中的诊断工具。目的：本研究旨在评估DTS作为心脏栓塞的诊断标志。方法：在回顾性队列研究中，我们注册了在大学医院的脑血管疾病苗圃中患上各种病因的急性缺血性卒中的连续患者。我们排除共存病因，不完全研究的患者，或者在计算机断层扫描上没有急性血管病变。没有考虑凝纹梗塞。脑血管局部分为右侧，左前方和后部。分析了急性血管病变，先前血管病变的存在，以及它们各自区域的定位。确定在时间，空间或DTS中的出现。结果：我们包括661名患者（平均年龄：74.05岁（SD：13.01））。心电图是大多数DTS的病因（30.47％的心脏栓塞中风）;在动脉粥样硬化亚型内更频繁地发生DT（9.88％）;在动脉分离组内更普遍（3.33％）。 DTS和患者之间的卒中病因有统计学显着差异，无传播（P <.001）。 DTS特异性81.67％，敏感度为30.47％，阳性预测值66.67％，对心脏栓塞的识别有49.40％的负面预测值。结论：DTS是心脏栓塞中风的特定诊断预测因子，可能有助于引导病因调查。 （c）2017国家冲程协会。由elsevier Inc.保留所有权利发布。

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