Predictive value of MRA, DWI and ABCD2 score for secondary cerebral infarction after transient ischemic attack / 中华老年医学杂志

ABSTRACT

Objective To evaluate the association of magnetic resonance angiography (MRA),diffusion-weighted imaging (DWI) and the ABCD2 score assessments with secondary cerebral infarction after transient ischemic attack (TIA).Methods Intracranial vascular MRA,cranial DWI and ABCD2 score were retrospectively analyzed in 162 cases with TIA.The impact of TIA on survival time was assessed using the univariate Kaplan-Meier curve by Log-rank test.Hazard ratio (HR) and 95 ％ confidence interval (CI) of secondary cerebral infarction after TIA predicted by MRA,DWI and ABCD2 score were analyzed by Cox multivariable regression.Results Among the 162 patients with first attack of TIA,86 cases (53.1 ％) developed cerebral infarction within 90 d,of which 22 cases (13.6％) developed secondary cerebral infarction within 0 7 d,27 cases (16.7％) within 8～30d and 37 cases (22.8％) within 31-90 d.Single factor analysis by Kaplan-Meier curve showed that moderate to severe intracranial vascular stenosis diagnosed by MRA,positive DWI and moderate to high ABCD2 score were obviously related to cerebral infarction after first attack of TIA (all P＜0.001 or 0.01).Cox multifactor risk model indicated that age ≥70 y,moderate to severe intracranial vascular stenosis,positive DWI,moderate to high ABCD2 score were the risk factors for secondary cerebral infarction within 90 d after TIA (HR=1.782,2.245,1.964,1.204,95％CI1.171-2.256,1.627 3.097,1.273-3.031,1.050-1.381,respectively,P＜0.05,0.01 or 0.001).Conclusions Intracranial artery stenosis examination may be more valuable than DWI and ABCD2 score in evaluating the outcome of TIA.