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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Transient Ischemic Attack Fast-track and Long-Term Stroke Risk: Role of Diffusion-Weighted Magnetic Resonance Imaging
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Transient Ischemic Attack Fast-track and Long-Term Stroke Risk: Role of Diffusion-Weighted Magnetic Resonance Imaging

机译：短暂性缺血攻击快速轨道和长期行程风险：扩散加权磁共振成像的作用

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Background: Acute ischemic lesions on diffusion-weighted magnetic resonance imaging (DWI-MRI) are reliable predictors of recurrent stroke at 90 days. However, to date, limited information on transient ischemic attack (TIA) patients with positive DWI lesions for stroke risk from 1 to 5 years is available. In this study, we evaluated the role of positive DWI lesions and vascular risk factors on stroke, cardiovascular death, and mortality at 90 days (T0), 1 year (T1), and 5 years (T2). Moreover, we also evaluated the association between stroke risk and the presence of DWI lesions. Methods: We performed an observational study on consecutive patients admitted to the emergency department of San Camillo-Forlanini Hospital, Rome, Italy, from January 2007 to November 2012. Over the study period, 4300 patients with TIA or ischemic stroke were examined by stroke specialists in an emergency room setting within 1 hour from admittance. Results: In 510 of 4300 patients (11.86%), a TIA was diagnosed, and 445 patients satisfy the study inclusion criteria. For all 445 patients, the mean ABCD2 score was 4.35 +/- 1.30. Using DWI-MRI, we identified acute ischemic lesions in 185 patients (41.57%). We did not observe any correlation between duration of symptoms, ABCD2 score, and positive or negative DWI lesions. Positivity for DWI was not associated with the presence of diabetes mellitus, hypertension, smoking habit, or age; however, an association with weakness was observed. We documented a time-dependent increase in the absolute risk of stroke: T0: 1.35% (95% confidence interval [CI], .81-2.8); T1: 4.78% (95%CI, 2.88-7.47); T2: 9.02% (95%CI, 4.66-5.70). We did not record any difference in stroke risk in patients with positive DWI lesions: T0: hazard ratio [HR], 1.43; 95%CI, .35-5.88; log-rank P = .60; T1: HR, 1.04; 95%CI, .42-2.61; log-rank P = .91; T2: HR, .83; 95%CI, .25-2.67; log-rank P = .86. Conclusions: This long-term follow-up study in TIA patients documents that both positive and negative DWI patients treated with fast-track had similar long-term risks of stroke.
机译：背景：扩散加权磁共振成像（DWI-MRI）上的急性缺血性病变是在90天内复发中风的可靠预测因子。然而，迄今为止，有关短期DWI病变的有限缺血攻击（TIA）患者的有限信息，可获得从1到5年的卒中风险的阳性DWI病变。在这项研究中，我们评估了阳性DWI病变和血管危险因素在90天（T0），1年（T1）和5年（T2）上对中风，心血管死亡和死亡率的作用。此外，我们还评估了行程风险与DWI病变的存在之间的关联。方法：我们从2007年1月到2012年1月到2012年1月到2012年11月录取了入院的连续患者的观察研究。在研究期间，卒中专家检查了4300例TIA患者或缺血性脑卒中在入场1小时内的急诊室设定。结果：在4300名患者的510名（11.86％）中，诊断出TIA，445名患者满足研究纳入标准。对于所有445名患者，平均ABCD2得分为4.35 +/- 1.30。使用DWI-MRI，我们在185名患者中鉴定了急性缺血性病变（41.57％）。我们没有观察症状持续时间与阳性或负DWI病变之间的任何相关性。 DWI的阳性与糖尿病，高血压，吸烟习惯或年龄的存在无关;然而，观察到与虚弱的关系。我们记录了中风的绝对风险的时间依赖性增加：T0：1.35％（95％置信区间[CI]，.81-2.8）; T1：4.78％（95％CI，2.88-7.47）; T2：9.02％（95％CI，4.66-5.70）。我们没有记录阳性DWI病变患者中风风险的任何差异：T0：危险比[HR]，1.43; 95％CI，.35-5.88;日志排名p = .60; T1：HR，1.04; 95％CI，.42-2.61;日志排名p = .91; T2：HR，.83; 95％CI，.25-2.67;日志排名p = .86。结论：TIA患者的这种长期随访研究患有快速轨道治疗的积极和阴性DWI患者的中风的长期风险。

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