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Relation between magnetic resonance diffusion-weighted imaging and TOAST classification, traditional risk factors of acute cerebral infarction
GENG Wen  JIANG Liang  CHEN Hui-you  XU Quan  YIN Xin-dao  ZHOU Jun-shan  ZHANG Ying-dong 

DOI:10.12015/issn.1674-8034.2018.06.012.


[Abstract] Objective: To study the relationship between magnetic resonance diffusion-weighted imaging (DWI) and trial of org 10172 in acute stroke treatment (TOAST) classification, traditional risk factors of acute cerebral infarction.Materials and Methods: Nine hundred and forty-two patients admitted to our hospital neurology department with acute cerebral infarction were enrolled. After DWI, the magnetic resonance DWI classification, clinical data such as age, hypertension and laboratory findings such as diabetes, blood fat were recorded. The TOAST of patients was classified according to them. The relationship between DWI and TOAST classification, traditional risk factors were analyzed.Results: In 942 cases of acute cerebral infarction patients, large artery atherosclerosis (LAA) type (49.04%) was the highest proportion, followed by small artery occlusion (SAO) (39.49%) and cardioembolism (CE) (6.16%), undetermined etiology (UND) (5.20%), other determined etiology (OC) (0.11%). The DWI was related with the TOAST classification in acute cerebral infarction patients (χ2=397.785, P=0.000). The cortical and subcortical infarction, the big penetrating branch infarction, unilateral anterior circulation infarction, anterior and posterior circulation infarction were mainly related with LAA type, and there were significant difference (P<0.05). The small penetrating branch infarction was mainly related with SAO type, and the difference was statistically significant (P<0.05). There were no significant between cortical infarction, bilateral anterior circulation infarction, posterior circulation infarction and TOAST (P>0.05). Age, NIHSS score, coronary heart disease, atrial fibrillation had significant difference between groups in DWI of 942 cases acute cerebral infarction (P<0.05). The average diameter of 434 cases with single lesions was 20.75±19.81, the significant difference was compared between groups (P=0.000); the average diameter of 508 patients with multiple lesions was (33.39±26.92) mm, the significant difference was compared between groups (P=0.000), the average minimum diameter is (5.20±3.27) mm, and there was no statistical difference between groups (P=0.513).Conclusions: DWI characteristics of patients with acute cerebral infarction has relationship with TOAST classification. The traditional risk factors such as age, NIHSS score, coronary heart disease, atrial fibrillation have a certain influence on DWI characteristics. Therefore, for patients with acute cerebral infarction, early DWI examination combined with the traditional clinical risk factors can guide the clinical diagnosis and select optimal treatment, so as to reduce the morbidity and mortality.
[Keywords] Stroke；TOAST classification；Diffusion weighted imaging；Magnetic resonance imaging

GENG Wen Department of Radiology, Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital), Nanjing 210006, China

JIANG Liang Department of Radiology, Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital), Nanjing 210006, China

CHEN Hui-you Department of Radiology, Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital), Nanjing 210006, China

XU Quan Department of Radiology, Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital), Nanjing 210006, China

YIN Xin-dao* Department of Radiology, Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital), Nanjing 210006, China

ZHOU Jun-shan Department of Neurology, Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital), Nanjing 210006, China

ZHANG Ying-dong Department of Neurology, Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital), Nanjing 210006, China

*Correspondence to: Yin XD, E-mail: y.163yy@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This work was part of Jiangsu Science and Technology Development Project No.BE2017614
Received  2018-02-26
Accepted  2018-04-28
DOI: 10.12015/issn.1674-8034.2018.06.012
DOI:10.12015/issn.1674-8034.2018.06.012.

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