国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Distribution and prognosis of acute ischaemic stroke with negative diffusion-weighted imaging

第一作者：Yu Wang,Jing Jing

通讯作者：Yongjun Wang

Stroke; Magnetic Resonance Imaging

基本信息

2022-06-13

已发表文章

发表杂志：stroke and vascular neurology

发表类型: Original Contributions

影响因子(IF): 9.893

PMID: 35697388 Pubmed原文链接 全文下载

主要研究背景及目的

Diffusion-weighted imaging (DWI) can help to diagnose acute ischemic stroke (AIS) precisely but DWI-negative can be found in considerable patients. Previous study shows that the prevalence of DWI-negative AIS is 6.8%. However, researches about the prognosis of AIS patient with DWI-negative are rarely seen and no conclusion has been reached. We aimed at exploring risk factors of DWI-negative and association with prognosis in AIS patients.

方法

Patients with AIS with baseline DWI from the Third China National Stroke Registry (CNSR-III), based on a prospective, observational, multicentre cohort study, between August 2015 and March 2018, were included. Patients were classified into negative and positive DWI groups depending on the existence of acute lesions on DWI.

结论

The proportion of patients with DWI-negative AIS gradually decreased as the NIHSS score increased, and negative DWI was mainly observed in patients with mild AIS. Negative DWI was associated with a better prognosis for all patients with AIS. However, these associations were significant for mild AIS but not for those with major AIS.

主要结果

Among 12 026 patients who had an ischaemic stroke, 932 (7.7%) had negative DWI. As the NIHSS score increased, the proportion of patients with DWI-negative AIS gradually decreased. Negative DWI was associated with a decreased risk of stroke recurrence (HR 0.63, 95% CI 0.49 to 0.82), combined vascular events (HR 0.72, 95% CI 0.56 to 0.92), mortality (HR 0.60, 95% CI 0.36 to 0.995) and poor functional outcomes (OR 0.57, 95% CI 0.43 to 0.76) within 1 year in all patients. Similar associations were observed in patients with mild AIS (p<0.05 for all) but not in patients with major AIS, excluding poor functional outcomes (OR 0.47, 95% CI 0.28 to 0.81).