| 邬家骏,刘鑫,朱松,倪婷,张大通,李晓兵,王征宇.液体衰减反转恢复序列血管高信号联合Willis环不完整及临床指标预测短暂性脑缺血发作继发脑梗死[J].中国医学影像技术,2026,42(5):662~666 |
| 液体衰减反转恢复序列血管高信号联合Willis环不完整及临床指标预测短暂性脑缺血发作继发脑梗死 |
| Fluid attenuation inversion recovery vascular hyperintensity combined with incomplete Willis circle and clinical indicators for predicting secondary cerebral infarction after transient ischemic attack |
| 投稿时间：2026-01-25 修订日期：2026-04-14 |
| DOI：10.13929/j.issn.1003-3289.2026.05.002 |
| 中文关键词: 脑缺血发作,短暂性 脑梗死 预后 磁共振成像 |
| 英文关键词:ischemic attack, transient brain infarction prognosis magnetic resonance imaging |
| 基金项目:奉贤区科委社会类科技发展基金(医学类)项目(奉科20250907)。 |
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| 中文摘要: |
| 目的 观察液体衰减反转恢复(FLAIR)序列血管高信号(FVH)联合Willis环不完整及临床指标预测短暂性脑缺血发作(TIA)继发脑梗死的价值。方法 回顾性纳入270例发病24 h内TIA患者,根据随访30 d是否继发脑梗死划分脑梗死组(n=86)与非脑梗死组(n=184);分别基于颅脑FLAIR序列及MR血管成像(MRA)评估FVH阳性[FVH(+)]及Willis环不完整。比较组间FVH阳性率、Willis环不完整率及临床指标,基于多因素logistic回归分析筛选TIA 30 d内继发脑梗死的独立预测因素并绘制列线图;绘制受试者工作特征曲线,计算曲线下面积(AUC)以评估列线图区分度,利用校准曲线评估模型校准度。结果 组间患者性别、年龄,合并糖尿病、TIA持续时间≥1 h占比,以及FVH阳性率及Willis环不完整率差异均有统计学意义(P均＜0.05)。多因素logistic回归分析显示,男性、高龄、合并糖尿病,TIA持续时间≥1 h、FVH(+)及Willis环不完整均为TIA 30 d内继发脑梗死的独立预测因素(P均＜0.05);所获列线图的AUC为0.913,且校准曲线显示其预测概率与实际观测概率基本一致。结论 基于FVH及Willis环不完整联合临床指标预测TIA后继发脑梗死效能良好。 |
| 英文摘要: |
| Objective To explore the value of fluid attenuation inversion recovery (FLAIR) vascular hyperintensity (FVH) combined with incomplete Willis circle and clinical indicators for predicting secondary cerebral infarction after transient ischemic attack (TIA). Methods A total of 270 TIA patients admitted to hospital within 24 h of onset were retrospectively enrolled and divided into infarction groups (n=86) and non-infarction (n=184) according to the occurrence of cerebral infarction within 30 days or not. Brain FLAIR and MR angiography (MRA) images were interpreted to assess FVH (+) and incomplete Willis circle. The positivity rate of FVH and incomplete Willis circle, as well as clinical indicators were compared between groups. Multivariable logistic regression analysis was used to identify independent predictors of secondary cerebral infarction within 30 days after TIA, and a nomogram was constructed. The receiver operating characteristic curve was drawn, and the area under the curve (AUC) was calculated to evaluate the discrimination of the obtained nomogram, and calibration curve was used to assess the calibration. Results Significant differences of patients’ gender, age, the proportion of complicated with diabetes mellitus, TIA duration ≥1 h, also the positivity rate of FVH and incomplete Willis circle were found between groups (all P＜0.05). Multivariable logistic regression analysis identified that male, advance aged, complicated with diabetes mellitus, TIA duration ≥1 h, FVH (+) and incomplete Willis circle were all independent predictors for secondary cerebral infarction within 30 days after TIA (all P＜0.05). The AUC of the obtained nomogram was 0.913, and calibration curve showed good agreement between predicted probabilities of the nomogram and the actual probabilities. Conclusion FVH combined with incomplete Willis circle and clinical indicators had good value for predicting secondary cerebral infarction after TIA. |
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