Transcranial color Doppler ultrasound quantitative analysis of the risk of early neurological deterioration in acute ischemic stroke patients and its effectiveness in predicting poor prognosis
10.3760/cma.j.cn115455-20201124-01666
- VernacularTitle:经颅彩色多普勒超声定量分析急性缺血性卒中患者早期神经功能恶化的风险及预测不良预后的效能
- Author:
Linlin HAN
1
;
Yuanjing LI
Author Information
1. 大连医科大学附属第二医院健康管理中心 116027
- Keywords:
Ultrasonography, Doppler, transcranial;
Stroke;
Prognosis;
Early neurological deterioration
- From:
Chinese Journal of Postgraduates of Medicine
2021;44(12):1144-1148
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the ability of predicting poor prognosis and the diagnosis efficacy of transcranial color Doppler ultrasound (TCCD) in acute ischemic stroke patients.Methods:A total of 264 AIS patients admitted to the Second Hospital of Dalian Medical University from January 2018 to March 2020 were selected and divided into early neurological deterioration (END) group (55 patients) and no END group (209 patients). The optic nerve sheath diameter (ONSD)/transverse eyeball diameter (ETD), middle cerebral artery pulsatility index (PI) and midline shift were detected by TCCD, and the results were analyzed.Results:The values of ONSD/ETD, PI and midline shift in the END group were higher than those in the no END group: 0.24 ± 0.02 vs. 0.22 ± 0.03, 1.26 ± 0.14 vs. 1.10 ± 0.12, (4.97 ± 1.13) mm vs. (3.41 ± 1.05) mm, and the differences were statistically significant ( P<0.05). The values of ONSD/ETD, PI, midline shift in the brain were positively correlated with the National Institutes of Health Stroke Scale (NIHSS) scores ( r1 = 0.531, r2 = 0.599, r3 = 0.566, all P<0.001). Multivariate analysis showed that NIHSS scores, blood glucose, ONSD/ETD, PI, brain midline shift values were related to END ( P<0.05). The prognostic area under the curve of the ONSD/ETD, PI, combined with brain midline shift values in assessing prognosis was 0.896, which was greater than any single index. The sensitivity was 84.62%, and the specificity was 89.08%. Conclusions:The detection of ONSD/ETD, PI and midline shift values by TCCD can provide important information for clinical assessment of the risk of END in AIS patients.
