The Relationship between Periventricular and Deep White Matter Damage Signals in T2 Flair Magnetic Resonance Imaging and Short-term Prognosis of rt-PA in Acute Ischemic Stroke
Objective To analyze the correlation between the signals of white matter damage near the ventricles and deep in T2 Flair magnetic resonance imaging and the short-term prognosis of acute ischemic stroke(AIS)treated with recombinant tissue plasminogen activator(rt PA)thrombolysis.Methods A total of 127 AIS patients treated with rt PA in our hospital from January 2018 to January 2022 were selected.Prior to rt PA treatment,all patients underwent MRI examination to obtain upper white matter hyperintensities(WMH),ventricular paraventricular hyperintensities(PVH),and deep white matter hyperintensities(DWMH)from the MRI T2 Flair sequence;Follow up for 90 days after rt PA treatment was conducted to record the patient's bleeding transformation at 24 hours,neurological deterioration(END)at 72 hours,and prognosis.The degree of WMH,PVH,and DWMH lesions in different populations was compared,and logistic regression analysis was performed to identify the relevant factors affecting the prognosis of AIS patients after rt PA treatment.Pearson analysis was used to investigate the relationship between WMH,PVH,DWMH and END,bleeding transformation,and prognosis in AIS patients.Results According to the follow-up data,among the 127 patients,26 cases(20.47％)experienced bleeding transformation 24 hours after thrombolytic therapy,and 39 cases(30.71％)experienced END 72 hours after treatment;44 cases(34.65％)had poor prognosis after 90 days;There was no statistically significant difference in the degree of WMH,PVH,and DWMH lesions between patients with and without hemorrhagic transformation(P＞0.05);The proportion of severe WMH and DWMH lesions in END patients was higher than that in non END patients(P＜0.05),and there was no significant difference in the degree of PVH lesions between the two groups(P＞0.05);There was a statistically significant difference in the degree of WMH lesions,DWMH lesions,bleeding transformation,END degree,NIHSS score at admission,and HDL-C between the poor prognosis group and the good prognosis group(P＜0.05);Logistic regression analysis was conducted with the 90 day prognosis as the dependent variable,and the results showed that bleeding conversion,END,NIHSS score at admission,severe WMH,DWMH,and HDL-C were independent risk factors affecting AIS patients after rt PA treatment(P＜0.05);Pearson analysis results showed that there was no significant correlation between the degree of WMH,PVH,and DWMH and the transformation of bleeding in patients(P＞0.05);The degree of PVH and END showed no significant correlation with prognosis(P＞0.05),while the degree of WMH and DWMH showed a positive correlation with END and prognosis(P＜0.05).Conclusion There is no significant correlation between the severity of WMH and DWMH lesions and the risk of bleeding transformation in AIS patients after rt PA treatment,but they have predictive value for the occurrence and prognosis of short-term adverse neurological function in patients.
Magnetic Resonance T2 FlairMiddle VentricleWhite MatterSignalAcute Ischemic StrokeThrombolysis
万方数据
维普
