Significance of HRMRI in subtyping NCAIS in the elderly / 中华老年心脑血管病杂志

ABSTRACT

Objective To investigate the diagnostic value of high-resolution magnetic resonance im-aging(HRMRI)in elderly patients with non-cardioembolic acute ischemic stroke(NCAIS).Meth-ods A retrospective analysis was conducted on 101 elderly NCAIS patients having HRMRI in our hospital from July 2022 to July 2023.Stroke subtypes were classified according to the Trial of Org 10172 in Acute Stroke Treatment(TOAST)system and the Chinese Ischemic Stroke Sub-classification(CISS)system.The constituent ratio distribution of each subtype classification was compared before and after HRMRI in both classification systems.Results TOAST system identi-fied 8 cases of small-artery occlusion(SAO),1 case of other determined etiology(SOE),5 cases of undetermined etiology(SUE)and then reclassified as large artery atherosclerosis(LAA),1 case of SUE which was reclassified as SAO,and 7 cases of LAA and 4 cases of SUE being reclas-sified as SOE after HRMRI.In total,the diagnosis of 26 cases(25.74％)was modified.In the CISS system,10 cases of penetrating artery disease(PAD),1 case of other etiologies(OE),and 4 cases of undetermined etiology(UE)were reclassified as LAA.Furthermore,9 cases of LAA and 3 cases of UE were reclassified as OE after HRMRI.In total,the diagnosis of 27 cases(26.73％)was modified.There were statistical differences in the constituent ratio before and after HRMRI in both TOAST(x2=15.425,P＜0.01)and CISS(x2=17.300,P＜0.01)systems.Conclusion HRMRI is of diagnostic value and significance in accurately diagnosing the etiology of AIS in eld-erly patients without cardioembolic causes.