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Clinical Article
Predictive value of cerebral blood tubule burden score for recurrent cerebrovascular events in patients with transient ischemic attack
JIANG Yanliu  WANG Shupei  LI Feng  ZHANG Lu 

Cite this article as: JIANG Y L, WANG S P, LI F, et al. Predictive value of cerebral blood tubule burden score for recurrent cerebrovascular events in patients with transient ischemic attack[J]. Chin J Magn Reson Imaging, 2024, 15(6): 67-71. DOI:10.12015/issn.1674-8034.2024.06.010.


[Abstract] Objective To investigate the predictive value of CSVD burden score for recurrent cerebrovascular events (RCVEs) in patients with transient ischemic attack (TIA).Materials and Methods A total of 182 patients with TIA who were treated in the Second People's Hospital of Anhui Province from October 2019 to December 2022 were selected as the research objects. The overall burden score of CSVD was calculated according to MRI examination. According to the presence or absence of RCVEs within 1 month of follow-up, they were divided into RCVEs group (n=46) and non-RCVEs group (n=136). The clinical data and CSVD total burden score were compared between the two groups. Multivariate logistic regression analysis model was used to analyze the independent risk factors of RCVEs. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of CSVD image feature score and total burden score for RCVEs in TIA patients.Results There were significant differences in the number of TIA attacks, duration of symptoms, history of hypertension, total burden score and classification of CSVD between the RCVEs group and the non-RCVEs group (P<0.05). Multivariate Logistic regression analysis showed that the number of TIA attacks, the duration of symptoms, and the total burden score of CSVD were independent risk factors for RCVEs in TIA patients (P<0.05). The results of ROC curve analysis showed that the areas under curve (AUC) of CSVD imaging marker score and total burden score in predicting RCVEs in TIA patients were 0.771 (95% CI: 0.673-0.869, P<0.001), 0.745 (95% CI: 0.655-0.835, P<0.001), 0.664 (95% CI: 0.549-0.780, P=0.009), 0.845 (95% CI: 0.766-0.924, P<0.001), 0.945 (95% CI: 0.896-0.994, P<0.001), respectively. The AUC predicted by CVSD total burden score was the highest. When the optimal cutoff value was 2 points, the sensitivity was 86.05% and the specificity was 83.02%.Conclusions The CSVD total burden score has a good predictive value for RCVEs in TIA patients, which is helpful for clinical evaluation of short-term prognosis in TIA patients.
[Keywords] transient ischemic attack;cerebral small vessel disease;magnetic resonance imaging;cerebral vascular burden score;recurrent cerebrovascular events;prognosis

JIANG Yanliu*   WANG Shupei   LI Feng   ZHANG Lu  

Department of Neurologic, Anhui Second People's Hospital, Hefei 230041, China

Corresponding author: JIANG Y L, E-mail: jiangyanliu66@163.com

Conflicts of interest   None.

Received  2023-10-20
Accepted  2024-05-10
DOI: 10.12015/issn.1674-8034.2024.06.010
Cite this article as: JIANG Y L, WANG S P, LI F, et al. Predictive value of cerebral blood tubule burden score for recurrent cerebrovascular events in patients with transient ischemic attack[J]. Chin J Magn Reson Imaging, 2024, 15(6): 67-71. DOI:10.12015/issn.1674-8034.2024.06.010.

[1]
MENDELSON SJ, PRABHAKARAN S. Diagnosis and management of transient ischemic attack and acute ischemic stroke: A review[J]. JAMA, 2021, 325(11): 1088-1098. DOI: 10.1001/jama.2020.26867.
[2]
WANG Y. Residual recurrence risk of ischaemic cerebrovascular events: concept, classification and implications[J]. Stroke Vasc Neurol, 2021, 6(2): 155-157. DOI: 10.1136/svn-2021-000885.
[3]
CHEN H, PAN Y, ZONG L, et al. Cerebral small vessel disease or intracranial large vessel atherosclerosis may carry different risk for future strokes[J]. Stroke Vasc Neurol, 2020, 5(2): 128-137. DOI: 10.1136/svn-2019-000305.
[4]
BIRNEFELD J, WÅHLIN A, EKLUND A, et al. Cerebral arterial pulsatility is associated with features of small vessel disease in patients with acute stroke and TIA: a 4D flow MRI study[J]. J Neurol, 2020, 267(3): 721-730. DOI: 10.1007/s00415-019-09620-6.
[5]
LI J, WU H, HANG H, et al. Carotid vulnerable plaque coexisting with cerebral small vessel disease and acute ischemic stroke: a Chinese Atherosclerosis Risk Evaluation study[J]. Eur Radiol, 2022, 32(9): 6080-6089. DOI: 10.1007/s00330-022-08757-9.
[6]
JIANG J, HUANG X, ZHANG Y, et al. TTotal MRI burden of cerebral vessel disease correlates with the progression in patients with acute single small subcortical strokes[J/OL]. Brain Behav, 2019, 9(1): e01173 [2023-10-20]. https://pubmed.ncbi.nlm.nih.gov/30506998/. DOI: 10.1002/brb3.1173.
[7]
CAO QL, SUN Y, HU H, et al. Association of cerebral small vessel disease burden with neuropsychiatric symptoms in non-demented elderly: A longitudinal study[J]. J Alzheimers Dis, 2022, 89(2): 583-592. DOI: 10.3233/JAD-220128.
[8]
Chinese Society of Neurology, Chinese Stroke Society. Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018[J]. Chin J Neurol, 2018, 51(9): 666-682. DOI: 10.3760/cma.j.issn.1006-7876.2018.09.004.
[9]
STAALS J, MAKIN S D, DOUBAL F N, et al. Stroke subtype, vascular risk factors, and total MRI brain small-vessel disease burden[J]. Neurology. 2014, 83(14): 1228-1234. DOI: 10.1212/WNL.0000000000000837.
[10]
KIM J M, PARK K Y, KIM H R, et al. Association of bone mineral density to cerebral small vessel disease burden[J/OL]. Neurology, 2021, 96(9): e1290-e1300 [2023-10-20]. https://pubmed.ncbi.nlm.nih.gov/33431517/. DOI: 10.1212/WNL.0000000000011526.
[11]
CEDRES N, FERREIRA D, MACHADO A, et al. Predicting Fazekas scores from automatic segmentations of white matter signal abnormalities[J]. Aging (Albany NY), 2020, 12(1): 894-901. DOI: 10.18632/aging.102662.
[12]
NAVIS A, GARCIA-SANTIBANEZ R, SKLIUT M. Epidemiology and outcomes of ischemic stroke and transient ischemic attack in the adult and geriatric population[J]. J Stroke Cerebrovasc Dis, 2019, 28(1): 84-89. DOI: 10.1016/j.jstrokecerebrovasdis.2018.09.013.
[13]
WANG A, MENG X, TIAN X, et al. Bleeding risk of dual antiplatelet therapy after minor stroke or transient ischemic attack[J]. Ann Neurol, 2022, 91(3): 380-388. DOI: 10.1002/ana.26287.
[14]
HURFORD R, WOLTERS F J, LI L, et al. Prevalence, predictors, and prognosis of symptomatic intracranial stenosis in patients with transient ischaemic attack or minor stroke: a population-based cohort study[J]. Lancet Neurol, 2020, 19(5): 413-421. DOI: 10.1016/S1474-4422(20)30079-X.
[15]
YANG S, ZHAO L, PEI L, et al. Nonfocal symptoms in patients with transient ischemic attack and association with stroke risk[J]. Curr Neurovasc Res, 2021, 18(5): 474-478. DOI: 10.2174/1567202619666211217124919.
[16]
SUNG P S, LEE K P, LIN P Y, et al. Factors associated with cognitive outcomes after first-ever ischemic stroke: The impact of small vessel disease burden and neurodegeneration[J]. J Alzheimers Dis, 2021, 83(2): 569-579. DOI: 10.3233/JAD-210587.
[17]
CHAUDHARY D, ABEDI V, LI J, et al. Clinical risk score for predicting recurrence following a cerebral ischemic event[J/OL]. Front Neurol, 2019, (10): 1106 [2023-10-20]. https://pubmed.ncbi.nlm.nih.gov/31781015/. DOI: 10.3389/fneur.2019.01106.
[18]
LUO Y, XIA L X, LI Z L, et al. Early neutrophil-to-lymphocyte ratio is a prognostic marker in acute minor stroke or transient ischemic attack[J]. Acta Neurol Belg, 2021, 121(6): 1415-1421. DOI: 10.1007/s13760-020-01289-3.
[19]
KESAV P, MENON D, VYSAKHA K V, et al. Differential distribution of cerebral microbleeds in subtypes of acute ischemic minor stroke and TIA as well as its association with vascular risk factors[J]. Neurol India, 2020, 68(5): 1139-1143. DOI: 10.4103/0028-3886.299147.
[20]
WANG B, YAO Z W, YANG R, et al. Comparison study of 3D-ASL combined with ABCD2 score and DSC-PWI combined with ABCD2 score in the evaluation of TIA[J]. Chinese Computed Medical Imaging, 2021, 27(3): 185-189. DOI: 10.3969/j.issn.1006-5741.2021.03.002.
[21]
CHENG Z, ZHANG W, ZHAN Z, et al. Cerebral small vessel disease and prognosis in intracerebral haemorrhage: A systematic review and meta-analysis of cohort studies[J]. Eur J Neurol, 2022, 29(8): 2511-2525. DOI: 10.1111/ene.15363.
[22]
OHARA T, UEHARA T, SATO S, et al. Small vessel occlusion is a high-risk etiology for early recurrent stroke after transient ischemic attack[J]. Int J Stroke. 2019, 14(9): 871-877. DOI: 10.1177/1747493019840931.
[23]
TIAN Y, PAN Y, YAN H, et al. Coexistent cerebral small vessel disease and multiple infarctions predict recurrent stroke[J]. Neurol Sci, 2022, 43(8): 4863-4874. DOI: 10.1007/s10072-022-06027-6.
[24]
LINDENHOLZ A, DE BRESSER J, VAN DER KOLK A G, et al. Intracranial atherosclerotic burden and cerebral parenchymal changes at 7T MRI in patients with transient ischemic attack or ischemic stroke[J/OL]. Front Neurol, 2021, 12: 637556 [2023-10-20]. https://pubmed.ncbi.nlm.nih.gov/34025551/. DOI: DOI:10.3389/fneur.2021.637556.
[25]
DU H, WU S, LEI H, et al. Total cerebral small vessel disease score and cerebral bleeding risk in patients with acute stroke treated with intravenous thrombolysis[J/OL]. Front Aging Neurosci, 2022, 14: 790262 [2023-10-20]. https://pubmed.ncbi.nlm.nih.gov/35478697/. DOI: 10.3389/fnagi.2022.790262.

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