孙定涛 1张民旺 2张荣恒 1李攀 1马洪宇 1邢漠1
作者信息
- 1. 郑州市中医院放射科,郑州 450000
- 2. 郑州市中医院脑病科,郑州 450000
- 折叠
摘要
Abstract
Objective To analyze the positive role of multi-sequence MRI combined with ABCD3 score in evaluating the risk of secondary cerebral infarction within 7 days after transient ischemic attack(TIA).Methods A total of 125 TIA patients admitted to Zhengzhou Hospital of Traditional Chinese Medicine from July 2021 to June 2024 were selected.The incidence of secondary cerebral infarction within 7 days was recorded,and patients were divided into a cerebral infarction group(15 cases)and a non-cerebral infarction group(110 cases).General clinical data,ABCD3 scores,and multi-sequence MRI findings were compared between the two groups.Multivariate logistic regression was used to identify risk factors for secondary cerebral infarction within 7 days post-TIA.The predictive value for cerebral infarction risk was assessed for the ABCD3 score alone and for the ABCD3 score combined with multi-sequence MRI(in series).Results Among the 125 TIA patients,the incidence of secondary cerebral infarction within 7 days was 12.00%(15/125).The cerebral infarction group showed significantly higher values than the non-cerebral infarction group in the following aspects:ABCD3 score(6.89±1.57 vs.4.50±1.03,t=7.859),the proportion of ipsilateral cerebrovascular stenosis(≥50%)[86.67%(13/15)vs.0%(0/110),χ2=107.469],the proportion of any vascular stenosis(≥50%)[86.67%(13/15)vs.3.64%(4/110),χ2=76.507],and the proportion of tortuous+stenotic vascular morphology[86.67%(13/15)vs.9.09%(10/110),χ2=52.907].All these differences were statistically significant(P<0.001).Multivariate logistic regression analysis identified ABCD3 score(OR=1.688,95%CI:1.192-2.387)the degree of ipsilateral cerebrovascular stenosis(OR=3.364,95%CI:1.350-6.105),any vascular stenosis(≥50%)(OR=2.875,95%CI:1.298-6.367),and cerebrovascular morphology(OR=2.573,95%CI:1.230-5.359)as independent risk factors for secondary cerebral infarction within 7 days after TIA(P<0.05).The sensitivity,specificity,accuracy,positive predictive value(PPV),and negative predictive value(NPV)of multi-sequence MRI combined with ABCD3 score for predicting secondary cerebral infarction within 7 days were 86.67%,90.91%,90.40%,56.52%and 98.04%,respectively.In contrast,the corresponding values for the ABCD3 score alone were 66.67%,81.82%,80.00%,33.33%,and 94.97%.The predictive performance of the combined approach was superior to that of the ABCD3 score alone.Conclusions Compared to using the ABCD3 score alone for predicting the risk of cerebral infarction within 7 days after TIA,incorporating multi-sequence MRI into the assessment significantly enhances predictive sensitivity,specificity,and accuracy.This integrated approach provides a more precise risk assessment tool for secondary infarction in TIA patients in clinical practice.关键词
MRI多序列扫描/ABCD3评分/短暂性脑缺血发作/脑梗死Key words
multi-sequence MRI/ABCD3 score/transient ischemic attack
