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磁共振液体衰减反转恢复序列血管高信号征对急性缺血性脑卒中预后的Meta分析
作者:董晓焕  翟冬枝 
单位:郑州大学第二附属医院 放射科, 河南 郑州 450000
关键词:磁共振 液体衰减反转恢复序列 血管高信号征 急性缺血性脑卒中 预后 Meta分析 队列研究 
分类号:R743.3;R445.2
出版年·卷·期(页码):2021·40·第五期(632-639)
摘要:

目的:探讨磁共振液体衰减反转恢复(FLAIR)序列成像血管高信号征(HVS)对急性缺血性脑卒中(AIS)患者的预后价值。方法:检索Embase、The Cochrane Library、PubMed、CNKI、VIP和WanFang数据库,搜索与磁共振FLAIR成像HVS对AIS患者预后价值分析相关的队列研究,检索时间为自建库至2021年1月31日。2名研究人员独立进行文献筛选、数据提取并对纳入研究进行偏倚风险评价后,应用RevMan 5.3软件对数据进行Meta分析。结果:纳入21个队列研究,包括2 328例AIS患者。Meta分析结果显示:同对照组比较,预后良好组患者的初始HVS评分更高(MD=0.73,95% CI为0.24~1.23,P=0.004),HVS(+)组与HVS(-)组患者预后差异无统计学意义(RR=0.83,95% CI为0.64~1.09,P=0.18),远端HVS组与无远端HVS组患者预后差异无统计学意义(RR=1.42,95% CI为0.47~4.32,P=0.53),HVS>4层组与HVS ≤ 4层组患者预后差异无统计学意义(RR=1.19,95% CI为0.51~2.75,P=0.69)。结论:初始HVS评分可以预测患者预后,预后良好组HVS评分高于预后不良组;HVS有无、是否远端、是否广泛分布对患者的预后无差异。

Objective: To review the prognostic value of fluid-attenuated inversion recovery (FLAIR) sequence imaging for hyperintensive vessel sign (HVS) in patients with acute cerebral infarction. Methods: Embase, The Cochrane Library, PubMed, CNKI, VIP and WanFang databases were searched to collect cohort studies on the prognostic value of MR FLAIR sequence imaging for HVS in patients with acute ischemic stroke from the time of self-built database built to January 31, 2021. Two researchers independently conducted literature screening data extraction and bias risk assessment, and then Meta-analysis was performed using RevMan 5.3 software. Results: Twenty-one cohorts, including 2 328 patients with acute cerebral infarction, were enrolled. The results showed that:the initial HVS score of patients in the good prognosis group was higher than that in the poor prognosis group (MD=0.73, 95% CI:0.24-1.23, P=0.004). The difference was not statistically significant in prognosis between the HVS positive and HVS negative groups(RR=0.83, 95% CI:0.64-1.09, P=0.18). The difference was not statistically significant in prognosis between the distal HVS group and the non-distal HVS group(RR=1.42, 95% CI:0.47-4.32, P=0.53). The difference was not statistically significant in the rate of good prognosis between HVS>4 slice and HVS ≤ 4 slice groups(RR=1.19, 95% CI:0.51-2.75, P=0.69). Conclusions: A comprehensive analysis including all of the included studies shows that a higher initial HVS score is beneficial for predicting patient outcomes. Positive and negative HVS, distal and non-distal HVS, and the prevalence of HVS do not predict patient prognosis.

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