摘要
Background: Based on previous observations of a high rate of ischemic lesion recurrence on diffusion-weighted imaging(DWI) within 1 week after an acute isc hemic stroke, the authors hypothesized that silent new ischemic lesions are comm on between 1 week and 90 days after index stroke and that early lesion recurrenc e may be associated with late lesion recurrence. Methods: The authors studied 80 acute ischemic stroke patients who had initial MRI performed within 48 hours, a nd follow-up scans at 5 days and at 30 or 90 days after onset. Early lesion re currences were defined as new ischemic lesions on 5-day DWI, and late lesion r ecurrences were defined as those on 30-or 90 day DWI or fluid attenuation inve rsion recovery image. Early lesion recurrence occurring outside the initial perf usion deficit was termed distant lesion recurrence. Results: Late lesion recurre nce occurred in 26% , more frequently observed on 30-day MRI than 90-day MR I (p = 0.016). Early lesion recurrence (OR 4.0; 95% CI 1.3 to 11.7) and distan t early lesion recurrence (OR 6.9; 95% CI 1.5 to 32.2) were independently asso ciated with late lesion recurrence by multiple logistic regression analyses. Con clusions: There may be a continued risk for recurrent ischemic lesions in the we eks following the clinically symptomatic stroke. Future studies are needed to in vestigate whether MRI defined ischemic lesion recurrences predict subsequent cli nical recurrence and thus may be a potential surrogate endpoint in stroke second ary prevention trials.
Background: Based on previous observations of a high rate of ischemic lesion recurrence on diffusion-weighted imaging(DWI) within 1 week after an acute isc hemic stroke, the authors hypothesized that silent new ischemic lesions are comm on between 1 week and 90 days after index stroke and that early lesion recurrenc e may be associated with late lesion recurrence. Methods: The authors studied 80 acute ischemic stroke patients who had initial MRI performed within 48 hours, a nd follow-up scans at 5 days and at 30 or 90 days after onset. Early lesion re currences were defined as new ischemic lesions on 5-day DWI, and late lesion r ecurrences were defined as those on 30-or 90 day DWI or fluid attenuation inve rsion recovery image. Early lesion recurrence occurring outside the initial perf usion deficit was termed distant lesion recurrence. Results: Late lesion recurre nce occurred in 26% , more frequently observed on 30-day MRI than 90-day MR I (p = 0.016). Early lesion recurrence (OR 4.0; 95% CI 1.3 to 11.7) and distan t early lesion recurrence (OR 6.9; 95% CI 1.5 to 32.2) were independently asso ciated with late lesion recurrence by multiple logistic regression analyses. Con clusions: There may be a continued risk for recurrent ischemic lesions in the we eks following the clinically symptomatic stroke. Future studies are needed to in vestigate whether MRI defined ischemic lesion recurrences predict subsequent cli nical recurrence and thus may be a potential surrogate endpoint in stroke second ary prevention trials.
出处
《世界核心医学期刊文摘（神经病学分册）》
2005年第5期37-37,共1页
Digest of the World Core Medical Journals:Clinical Neurology
