国际医药卫生导报2025，Vol.31Issue(12)：1953-1958,6.DOI:10.3760/cma.j.cn441417-20250115-12004
基于磁共振高分辨血管壁成像指标分析大脑中动脉狭窄性缺血性脑卒中患者预后的影响因素
Factors influencing prognosis of patients with middle cerebral artery stenosis ischemic stroke based on MRI high-resolution vascular wall imaging indicators
摘要
Abstract
Objective To explore the prognostic factors influencing the prognosis of patients with middle cerebral artery(MCA)stenosis(CIS)ischemic stroke based on high-resolution vascular wall imaging indicators using magnetic resonance imaging(MRI).Methods This study was a retrospective study.Eighty patients with poor prognosis of MCA stenosis ischemic stroke admitted to Xuzhou First People's Hospital from January 2020 to May 2024 were selected as a study group(the score of Rankin scale≤2 after discharge for 3 months);there were 49 males and 31 females;they were(58.54±9.54)years old.Another 98 patients with good prognosis of MCA stenosis ischemic stroke admitted during the same period were selected as a control group;there were 61 males and 37 females;they were(60.01±10.67)years old.The clinical data and MRI high-resolution vascular wall imaging indicators were compared between the two groups.The risk factors for the poor prognosis in the patients with MCA stenosis ischemic stroke were analyzed by the multiple logistic regression analysis.The regression equation was constructed,and a receiver operating characteristic curve(ROC)was drawn to analyze the predictive value of the regression equation for the prognosis of the patients with MCA stenosis ischemic stroke.x2 and independent-sample t tests were used for the statistical comparisons.Results The proportion of the patients with severe stenosis or occlusion of the MCA in the study group was higher than that in the control group[75.00％(60/80)vs.23.47％(23/98);P＜0.05].The score of Glasgow Coma Scale(GCS)in the study group was lower than that in the control group,and the score of National Institutes of Health Stroke Scale(NIHSS)of the United States was higher(both P＜0.05).The narrowest lumen area in the study group was smaller than that in the control group(P＜0.05);the T1 weighted imaging(T1WI)signal intensity index,T2 weighted imaging(T2WI)signal intensity index,plaque enhancement rate,and wall normalization index(NWI)in the study group were higher than those in the control group(all P＜0.05);the total vascular area(TVA)and wall area(WA)in the study group were greater than those in the control group(both P＜0.05).The results of multiple logistic regression analysis showed that severe stenosis or occlusion of the MCA(OR=1.966),a high score of NIHSS(OR=2.784),a small lumen area at the narrowest point(OR=2.396),a high T1WI signal intensity index(OR=1.988),a high T2WI signal intensity index(OR=3.047),a high NWI(OR=1.721),a large TVA(OR=2.221),and a large WA(OR=2.998)were independent risk factors for poor prognosis in the patients with MCA stenosis ischemic stroke(all P＜0.05).The regression equation was constructed.According to the diagnostic probability logit(P),the ROC was drawn to predict the poor prognosis in the patients.When logit(P)＞11.73,the area under the curve(AUC)and x2 value were 0.872 and 13.596,respectively,with a 95％CI of 0.814-0.917.The diagnostic sensitivity and specificity were 85.00％and 79.59％,respectively.Conclusions Severe stenosis or occlusion of the MCA,a small lumen area at the narrowest point,a high score of NIHSS,a high T1WI signal intensity index,a high T2WI signal intensity index,a high NWI,a large TVA,and a large WA are independent risk factors for poor prognosis in patients with MCA stenosis ischemic stroke.The regression equation has high predictive value.关键词
磁共振/高分辨血管壁成像/大脑中动脉狭窄/缺血性脑卒中/预后/影响因素Key words
Magnetic resonance/High-resolution vascular wall imaging/Middle cerebral artery stenosis/Ischemic stroke/Prognosis/Influencing factors引用本文复制引用
张学勤,曹伟,孙向征,王暖,杨浩然..基于磁共振高分辨血管壁成像指标分析大脑中动脉狭窄性缺血性脑卒中患者预后的影响因素[J].国际医药卫生导报,2025,31(12):1953-1958,6.基金项目
江苏省卫生健康委科研项目(Z2023062) Scientific Research Project of Jiangsu Health Commission(Z2023062) （Z2023062）
