■颅外椎动脉夹层(EVAD)是中青年患者中风的主要原因之一。然而,诊断具有挑战性。本研究旨在识别EVAD在彩色双工超声(CDU)和高分辨率磁共振成像(hrMRI)中的特征,希望提高准确性并确定血管发现和临床因素对急性缺血事件的相对贡献。
■招募单侧EVAD患者,并将其分为缺血组和非缺血组。患者的临床特征和病变位置;指示夹层的各种体征,包括内膜瓣的存在,双腔,壁内血肿,夹层动脉瘤,管腔内血栓,和不规则的管腔;并审查了CDU和hrMRI上每个解剖段的其他定量参数,分别。进行多元logistic回归分析以探讨临床,成像特性,单侧EVAD患者的缺血事件。
■符合纳入标准的96名单侧EVAD患者在6年期间被纳入。总的来说,41例(42.7%)在症状发作后48h内被证实为缺血性卒中(n=40)或短暂性脑缺血发作(n=1)。男人,上周的感染,吸烟在缺血组更为常见。与无脑缺血患者相比,CDU上的腔内血栓和闭塞在脑缺血患者中更为普遍(36.6vs.5.5%;p<0.001,39.0vs.9.1%;p=0.001)。在核磁共振成像上,缺血组的腔内血栓和闭塞也比非缺血组更常见(34.1vs.5.5%;p<0.001,和34.1vs.9.1%;p分别=0.003)。此外,缺血患者在hrMRI上的病变长度明显更长(81.5±41.7vs.64.7±30.8mm;p=0.025)。在多变量逻辑回归分析中,男性,上周的感染,CDU和hrMRI显示管腔内血栓的存在与急性缺血事件独立相关。
■男性,上周的感染,在单侧EVAD患者中,由于夹层导致的管腔内血栓的存在与缺血事件的风险增加相关.
UNASSIGNED: Extracranial vertebral artery dissection (EVAD) is one of the main causes of stroke in young and middle-aged patients. However, the diagnosis is challenging. This
study aimed to identify the characteristics of EVAD on color duplex ultrasonography (CDU) and high-resolution magnetic resonance imaging (hrMRI), hoping to improve the accuracy and determine the relative contribution of vessel findings and clinical factors to acute ischemic events.
UNASSIGNED: Patients with unilateral EVAD were recruited and divided into ischemia and non-ischemia groups. Clinical features of patients and the lesion location; a variety of signs which indicate dissection, including the presence of an intimal flap, double lumen, intramural hematoma, dissecting aneurysm, intraluminal thrombus, and irregular lumen; and other quantitative parameters of each dissected segment on CDU and hrMRI were reviewed, respectively. Multiple logistic regression was performed to explore the association between clinical, imaging characteristics, and ischemic events in patients with unilateral EVAD.
UNASSIGNED: Ninety-six patients with unilateral EVAD who met the inclusion criteria were enrolled during a six-year period. Overall, 41 cases (42.7%) were confirmed as ischemic stroke (n = 40) or transient ischemic attack (n = 1) during the 48 h after the onset of symptoms. Men, infections during the last week, and smoking were more common in the ischemia group. Intraluminal thrombus and occlusion on CDU were more prevalent in patients with cerebral ischemia than in those without (36.6 vs. 5.5%; p < 0.001, and 39.0 vs. 9.1%; p = 0.001, respectively). On hrMRI, intraluminal thrombus and occlusion were also more frequent in the ischemia group than in the non-ischemia group (34.1 vs. 5.5%; p < 0.001, and 34.1 vs. 9.1%; p = 0.003, respectively). In addition, lesion length on hrMRI was significantly longer for patients with ischemia (81.5 ± 41.7 vs. 64.7 ± 30.8 mm; p = 0.025). In multivariable logistic regression analysis, male gender, infections during the last week, and the presence of intraluminal thrombus on CDU and hrMRI were independently associated with acute ischemic events.
UNASSIGNED: Male sex, infections during the last week, and the presence of intraluminal thrombus due to dissection are associated with an increased risk of ischemic events in patients with unilateral EVAD.