Analysis And Study Of Image Characteristics Of Brainstem Raphe In Patients With Post-stroke Depression By Transcranial Sonography

Background and objective:Poststroke depression(PSD)is one of the most common neuropsychiatric complications in the clinic of stroke patients,which can exist in the whole course of stroke.Clinically,it has been shown that the prognosis of PSD patients is poor,recurrent vascular events and death rates are more harmful.The poor living quality of patients can bring heavy burden to the patient,their families,and even society.Therefore,early effective diagnosis and treatment can achieve very good results,especially for patients with PSD.Since the clinicians pay much attention to the body issue,PSD is easy to be ignored in clinical practice.It requires professional neurologists and two different data analysis models of HAM-D are studied together.This research mainly applies transcranial sonography(TCS)to detect the changes of intracranial raphe(BR)echo in patients with ischemic stroke and its correlation with the HAM-D score,and then to explore the diagnostic value of TCS technology inPSD patients.Materials and methods:From March 2019 to December 2020,there are 195 patients with definite Stroke and highly suspected of depression.They are all given HAM-D analysis and other related diagnosis,The TCS test was performed by a professional examiner who was not aware of the clinical data and was reanalyzed by another examiner who was not.While checking,the ultrasonic instrument was adjusted to TCS detection mode,the optimal position of the temporal window for testing,and then applied the standard axial image detection to the situation of the midbrain raphe BR echo,normal person is shown as continuous hyperechoic thin line samples.If the BR is still absent or interrupted,or if the red nucleus is the standard,the BR echo is reduced relatively to its echo,then it is considered abnormal.However,due to the different temporal window conditions of patients,21 patients who could not obtain better TCS images were excluded,and the remaining 174 patients were included in this study.According to the HAM-D score and the evaluation strategies,ischemic stroke patients can be divided into the PSD group141 examples,none PSD(nPSD)group of 33 cases,comparison of PSD group and nPSD group Differences,and calculate the TCS BR echoes detected change applied to diagnose the suspected PSD patients after ischemic stroke patients with PSD of the sensitivity,specificity and accuracy.The degree of depression is evaluated according to the HAM-D score and divided into four levels.≤7 is no form,8-17 is typically mild,and 18-24 is particularly moderate;≥25 is classified as severe depression.BR echo was then divided into four grades.Grade 1-4 indicated BR echo loss,discontinuous interrupt,echo reduction and continuous normal echo respectively.Finally,chi-square test of the correlation between two ordinal categorical variables was used to analyze the correlation between BR echo grading and HAM-D scoring grade.Results:1.General information Among the 174 patients included in this study,96 men and78 women,their age were about 35-88,and the average result was 65.41 ± 10.28,BMI 25.56±10.52 kg/m2,141 cases in the PSD group(72 males,69 females),aged39-88 years,average 66.02 ± 10.49 years old,stroke duration 24.00(0.66,48.00)months,HAM-D score 17(13,21),and the HAMA scale score was 21(16,25).Total number,male and female number,age range,and average age of nPSD group were 33,24,and 9,47 to 73 years old and 62.82±9.34 years old,respectively.The course of stroke was 6.00(0.10,60.00)months,and HAM-D scale score was 4(2,6)and HAMA scale score was 6(1,7).There were no differences in age,stroke duration and BMI between the two groups(P > 0.05);HAM-D score and gender composition were significantly different(P < 0.05).2.Using TCS to evaluate the qualitative data of whether there are abnormal changes in the BR echo between the PSD group and the nPSD group,the repeatability test Kappa value is 0.893.3.The BR data of this small group reached(75.9%,107/141),which was significantly higher than that in nPSD group(9.1%,3/33),It can be concluded that there is a certain statistical value between them,or reached(31.25,P < 0.01).4.The sensitivity,specificity and accuracy of TCS analysis of abnormal BR echo in the diagnosis of stroke patients with depression are 75.9%,90.9% and 78.7%,respectively,with good specificity.5.The score of depression of patients with this type of disease and the linear data result of BR analysis(χ 2 = 58.111,P <0.01).The correlation result shows that there was a negative correlation between BR echo grade and depression score of stroke patients(R= 0.580,P <0.01).Conclusions:By applying the TCS to detect the intracranial BR echo changes of cerebral apoplexy patients,it has been confirmed that the application of TCS technology can provide practical value for the diagnosis of PSD patients,and it has good repeatability,specificity and sensitivity.It will also play an obvious effect on the treatment of PSD and provide an effective supplement to those who cannot fully cooperate with the depression scale detection,so that the clinical doctors to early intervention and treatment in patients with PSD,become another simple objective complementary diagnosis tool for depression assessment besides the depression scale.