The TOAST Classification And Imaging Characteristics In Acute Stroke With Different Treatment Methods

Objective: To analyze the TOAST classification and imaging features of acute stroke with different therapies by using multi-mode magnetic resonance diffusion weighted imaging-perfusion weighted imaging.Materials and Methods: One hundred and ten patients admitted to our hospital neurology department with acute stroke were retrospectively analyzed.All patients were performed multi-mode magnetic resonance examination,the imaging findings,clinical data and laboratory findings were recorded.Senior neuroimaging physician evaluated the DWI and TOAST of patients according to them.The patients were divided into vein thrombolysis group(43 cases),artery bolt group(34 cases)and conservative treatment group(33 cases),and the imaging and clinical data of three groups were statistically analyzed.Results:(1)The ratio of ischemic penumbra and Hyperintense vessel in artery bolt group were higher than the ratio of vein thrombolysis and conservative treatment group,the difference is statistically significant.(2)In terms of DWI classification,the small penetrating branch infarction and unilateral anterior circulation infarction for lager ratio in vein thrombolysis group(25.58%,23.26%),unilateral anterior circulation infarction and anterior-posterior circulation infarction for lager ratio in artery bolt group(52.94%,21.43%)and conservative treatment group(30.30%,30.30%).(3)In terms of TOAST classification,LAA for lager ratio in vein thrombolysis group(39.53%),UND for lager ratio in artery bolt group,SAO for conservative treatment group.(4)In terms of MRA imaging findings,both middle cerebral artery and Internal carotid artery showed the highest proportion of normal in intravenous thrombolysis and conservative treatment group(72.09%,51.52%),and middle cerebral artery stenosis or occlusion showed the highest proportion in artery bolt group(41.18%).(5)Artery bolt group had the highest bleeding conversion rate in the three groups(26.47%),the difference was statistically significant(F=6.462,P=0.040).(6)Hospital NIHSS score and hyperlipidemia in the three groups had statistical difference(t=6.209,P=0.003;F=6.176,P=0.046).(7)the onste time in conservative treatment group(6.55±4.70)was longer than that in intravenous thrombolysis group(2.93±1.05)and artery bolt group(3.07±2.51).There were significant difference in three groups(t=16.246,P=0.000).Conclusion: Knowledge of the imaging findings of patients with different treatment characteristics,can help clinical doctors choose reasonable treatment scheme according to the concrete situation,realize the personalized treatment.