摘要
目的 探讨一种基于多模态磁共振成像(MRI)特征建立的短暂性脑缺血发作(TIA)后发生脑卒中风险的预测模型,以降低TIA后进展为脑卒中的发生风险。方法 前瞻性收集首次发生TIA的患者103例,随访至90天(期间如发生脑卒中终止随访)。分析TIA后患者的基线MRI特征及临床资料。采用单因素和多因素logistic回归分析,确定TIA后脑卒中的独立危险因素,建立列线图模型。采用受试者工作特征(ROC)曲线评估其诊断效能。结果 TIA后脑卒中的发生率为10.7%,将其分成TIA后脑卒中组11例,TIA后无脑卒中组92例,两组间的年龄、脑室周围白质高信号(PWMH)、深部白质高信号(DWMH)、脑动脉硬化差异有统计学意义(P<0.05)。多因素分析显示PWMH、脑动脉硬化是TIA后脑卒中的独立危险因素(OR=5.696、3.183,P=0.001、0.049),纳入PWMH、脑动脉硬化建立TIA后脑卒中的列线图模型,预测模型诊断TIA后脑卒中的曲线下面积(AUC)为0.880,高于单独PWMH、DWMH、脑动脉硬化、年龄的AUC(0.838、0.797、0.787、0.733)。结论 基于TIA后基线的多模态MRI特征建立的列线图模型,可以提供一种潜在、无创的方法预测TIA后发生脑卒中的风险。
Objective To establish a predictive model of stroke risk after transient ischemic attack(TIA)based on multi-modal magnetic resonance imaging(MRI)to reduce the risk of stroke progression after TIA.Methods A total of 103 patients who experienced TIA for the first time were prospectively collected and followed up for 90 days(the follow-up was terminated if stroke occurred during the period).Baseline MRI features and clinical data of patients with TIA were analyzed.Univariate and multivariate logistic regression analysis was used to determine the independent risk factors of stroke after TIA,and a nomogram model was established.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficiency.Results The incidence of stroke after TIA was 10.7%,which was divided into 11 cases in the post-TIA stroke group and 92 cases in the non-stroke group.There were statistically significant differences in age,periventricular high white matter signal(PWMH),deep white matter high signal(DWMH)and cerebral arteriosclerosis between the two groups(P<0.05).Multivariate analysis showed that PWMH and cerebral arteriosclerosis were independent risk factors for stroke after TIA(OR=5.696,3.183,P=0.001,0.049).PWMH and cerebral arteriosclerosis were included to establish a histogram model for stroke after TIA.The area under the curve(AUC)of the predictive model for diagnosing stroke after TIA was 0.880,which was higher than the AUC of PWMH,DWMH,cerebral arteriosclerosis and age alone(0.838,0.797,0.7870.733).Conclusion A nomogram model based on multi-modal MRI features at baseline after TIA may provide a potential,non-invasive way to predict the risk of stroke after TIA.
作者
葛玉杰
章先锋
毛晓铧
闫雪
唐炎良
李志平
GE Yujie;ZHANG Xianfeng;MAO Xiaohua;YAN Xue;TANG Yanliang;LI Zhiping(Department of Radiology,Hangzhou Fuyang Hospitai of Traiditional Chinese Medicine,Hangzhou 311400,China;Department of Neurology,Hangzhou Fuyang Hospitai of Traiditional Chinese Medicine,Hangzhou 311400,China;Department of Radiology,Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou 310007,China)
出处
《医学影像学杂志》
2025年第3期6-10,共5页
Journal of Medical Imaging
基金
浙江省杭州市卫生科技计划(编号:B20200345)。
关键词
短暂性脑缺血发作
脑卒中
磁共振成像
模型
Transient ischemic attack
Stroke
Magnetic resonance imaging
Model
