PDF(Pubmed)
Abstract：
UNASSIGNED: Transcranial Doppler (TCD) and brain MRI may be useful in evaluating patients with APS, helping to stratify the risk of cerebrovascular ischaemic events in this population. This study aimed to assess the frequency of brain MRI abnormalities in patients with primary antiphospholipid syndrome, secondary antiphospholipid syndrome and SLE and correlate to TCD findings.
UNASSIGNED: The study, conducted over four years at two autoimmune disease referral centres, included 22 primary antiphospholipid syndrome patients, 24 secondary antiphospholipid syndrome patients, 27 SLE patients without APS and 21 healthy controls. All participants underwent TCD to assess cerebral haemodynamics, detect microembolic signals and evaluate right-to-left shunts, followed by brain MRI and magnetic resonance angiography. MRI scans were reviewed for acute microembolism, localized cortical infarctions, border infarctions, lacunar infarctions, ischaemic lesions, white matter hyperintensity, micro and macro haemorrhages and arterial stenosis ≥50% of the cervical carotid artery, by two neuroradiologists blinded to the clinical data.
UNASSIGNED: Brain MRI findings were similar between the groups, except for lacunar infarction, more frequent in patients with secondary antiphospholipid syndrome (P = 0.022). Patients with intracranial stenosis detected by TCD had a higher frequency of territorial infarction (40% vs 7.5%, P = 0.02), lacunar (40% vs 11.3%, P = 0.075) and border zone infarcts (20% vs 1.9%, P = 0.034).
UNASSIGNED: Patients with intracranial stenosis presented a higher frequency of territorial, lacunar and border zone infarcts, suggesting that evaluating the intracranial vasculature should not be neglected in patients with APS and stroke.
UNASSIGNED: The study, conducted over four years at two autoimmune disease referral centres, included 22 primary antiphospholipid syndrome patients, 24 secondary antiphospholipid syndrome patients, 27 SLE patients without APS and 21 healthy controls. All participants underwent TCD to assess cerebral haemodynamics, detect microembolic signals and evaluate right-to-left shunts, followed by brain MRI and magnetic resonance angiography. MRI scans were reviewed for acute microembolism, localized cortical infarctions, border infarctions, lacunar infarctions, ischaemic lesions, white matter hyperintensity, micro and macro haemorrhages and arterial stenosis ≥50% of the cervical carotid artery, by two neuroradiologists blinded to the clinical data.
UNASSIGNED: Brain MRI findings were similar between the groups, except for lacunar infarction, more frequent in patients with secondary antiphospholipid syndrome (P = 0.022). Patients with intracranial stenosis detected by TCD had a higher frequency of territorial infarction (40% vs 7.5%, P = 0.02), lacunar (40% vs 11.3%, P = 0.075) and border zone infarcts (20% vs 1.9%, P = 0.034).
UNASSIGNED: Patients with intracranial stenosis presented a higher frequency of territorial, lacunar and border zone infarcts, suggesting that evaluating the intracranial vasculature should not be neglected in patients with APS and stroke.
摘要：
■经颅多普勒（TCD）和脑MRI可能有助于评估APS患者，有助于对该人群的脑血管缺血事件的风险进行分层。本研究旨在评估原发性抗磷脂综合征患者脑MRI异常的频率。继发性抗磷脂综合征和SLE，并与TCD发现相关。
■这项研究，在两个自身免疫性疾病转诊中心进行了四年，包括22例原发性抗磷脂综合征患者，24例继发性抗磷脂综合征患者，27例无APS的SLE患者和21例健康对照。所有参与者都接受了TCD以评估脑血流动力学，检测微栓子信号并评估从右到左分流，其次是脑部MRI和磁共振血管造影。对急性微栓塞的MRI扫描进行了回顾，局部皮质梗死,边界梗塞,腔隙性梗塞,缺血性病变,白质高强度，微小和大出血和动脉狭窄≥颈部颈动脉的50％，两名神经放射学家对临床数据视而不见。
■两组的脑部MRI检查结果相似，除了腔隙性脑梗死,继发性抗磷脂综合征患者更常见(P=0.022)。TCD发现颅内狭窄的患者有较高的区域梗死频率（40％vs7.5％，P=0.02),腔隙(40%对11.3%，P=0.075）和边界区梗死（20%vs1.9%，P=0.034)。
■颅内狭窄的患者出现较高的区域频率，腔隙和边界区梗塞，提示在APS和卒中患者中不应该忽视颅内血管的评估。
■这项研究，在两个自身免疫性疾病转诊中心进行了四年，包括22例原发性抗磷脂综合征患者，24例继发性抗磷脂综合征患者，27例无APS的SLE患者和21例健康对照。所有参与者都接受了TCD以评估脑血流动力学，检测微栓子信号并评估从右到左分流，其次是脑部MRI和磁共振血管造影。对急性微栓塞的MRI扫描进行了回顾，局部皮质梗死,边界梗塞,腔隙性梗塞,缺血性病变,白质高强度，微小和大出血和动脉狭窄≥颈部颈动脉的50％，两名神经放射学家对临床数据视而不见。
■两组的脑部MRI检查结果相似，除了腔隙性脑梗死,继发性抗磷脂综合征患者更常见(P=0.022)。TCD发现颅内狭窄的患者有较高的区域梗死频率（40％vs7.5％，P=0.02),腔隙(40%对11.3%，P=0.075）和边界区梗死（20%vs1.9%，P=0.034)。
■颅内狭窄的患者出现较高的区域频率，腔隙和边界区梗塞，提示在APS和卒中患者中不应该忽视颅内血管的评估。
