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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Pilot Study of Cardiac Magnetic Resonance Imaging for Detection of Embolic Source After Ischemic Stroke
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Pilot Study of Cardiac Magnetic Resonance Imaging for Detection of Embolic Source After Ischemic Stroke

机译：心脏磁共振成像检测缺血性卒中后栓塞源的试验研究

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Background: Transesophageal echocardiography (TEE) is the standard for evaluating cardioembolic sources of stroke, although many strokes remain cryptogenic after TEE. Cardiac magnetic resonance (CMR) imaging may have advantages over TEE. We performed a prospective pilot study comparing CMR to TEE after stroke to assist in planning future definitive studies. Methods: Individuals with nonlacunar stroke within 90 days of undergoing clinical TEE were prospectively identified and underwent a 1.5 Tesla research CMR scan. Exclusion criteria included >50% relevant cervical vessel stenosis and inability to undergo nonsedated CMR. A descriptive comparison of cardioembolic source (intracardiac thrombus/mass, aortic atheroma 2:4 mm, or patent foramen ovale [PFO]) by study type was performed. Results: Twenty patients underwent CMR and TEE a median of 6 days apart. The median age was 51 years (interquartile range [IQR] 40, 63.5), 40% had hypertension, 15% had diabetes, 25% had a previous stroke/transient ischemic attack, 5% had atrial fibrillation, and none had coronary disease or heart failure. No patient had intracardiac thrombus or mass detected on either study. Aortic atheroma 2:4 mm thick was identified by TEE in 1 patient. CMR identified aortic atheroma as <4 mm in this patient (3 mm on CMR compared with 5 mm on TEE). PFO was identified in 6 of 20 patients on TEE; CMR found only 1 of these. Conclusions: In this pilot study, TEE identified more potential cardioembolic sources than CMR imaging. Future studies comparing TEE and CMR after stroke should focus on older subjects at higher risk for cardiac disease to determine whether TEE, CMR, or both can best elucidate potential cardioembolic sources.
机译：背景：经细胞眼科超声心动图（TEE）是评估心脏栓子源中风来源的标准，尽管在T恤之后许多笔触仍然保持密集内。心脏磁共振（CMR）成像可能具有优于TEE的优点。我们在中风后进行了一项预期试验研究，将CMR与TEE进行了帮助，以协助规划未来的明确研究。方法：前瞻性地确定了在接受临床TEE后90天内的非裂缝中风的个体，并经历了1.5特斯拉研究CMR扫描。排除标准包括> 50％相关宫颈血管狭窄和无法接受废除CMR。进行了通过研究类型进行了心脏栓塞源（心绞痛血栓/质量，主动脉瘤2：4mm或专利诱捕ovale ovale [PFO]）的描述性比较。结果：二十名患者接受了CMR和T恤的中位数分开6天。中位年龄为51岁（综合排列[IQR] 40,63.5），40％的高血压，15％患有糖尿病，25％的中风/短暂性缺血发作，5％的心房颤动，没有冠状动脉疾病心脏衰竭。没有患者在任何一种研究中检测到血栓血栓或肿块。 1例患者在1例患者中鉴定了主动脉粥样瘘2：4mm厚。 CMR将主动脉动脉粥样波动粥样主动脉粥样菌状物（CMR在CMR上3mm，与T恤上的5mm）相比）。 PFO在T恤中的6例中有6例鉴定出来; CMR只发现其中的1个。结论：在这项试验研究中，TEE确定了比CMR成像更多的潜在的心脏病来源。未来的研究比较TEE和CMR后冲程后应该关注心脏病风险较高的较老体，以确定TEE，CMR或两者是否可以最佳地阐明潜在的心电图来源。

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