| Objective:This study explored the independent risk factors for FLAIR Vascular Hyperintensity(FVH)in patients with acute ischemic stroke,the correlation between FVH and the position or the degree of stenosis on responsible blood vessels and its impact in prognosis the acute phase.At the same time,we further analyzed the significance of FVH and Diffusion Weighted Imaging(DWI)mismatch on assessment the condition of patients with acute ischemic stroke and the impact on the prognosis of the acute phase.Methods:Continuous collection of patients with acute ischemic stroke admitted in our department from 2016.01 to 2020.01.Inclusion patients must meet the entry criteria,collect relevant clinical data in detail.Divided into two groups according to whether FVH is positive,compare the baseline data of FVH positive group and FVH negative group,logistic multivariate regression was used to analyze the independent risk factors of FVH.Compare the difference of stenosis position and stenosis degree of middle cerebral artery between FVH positive group and FVH negative group.Univariate and multivariate logistic regressions were used to analyze whether FVH was an independent prognostic factor for exacerbation of acute stage.According to whether the patients’ FVH and DWI match,they are divided into two groups,compare the baseline data of the two groups,logistic multivariate regression analysis of independent risk factors for FVH-DWI mismatch,Receive Operating Characteristic Curve(ROC)was used to analyze the value of DWI-ASPECTS score to predict FVH-DWI mismatch.Logistic multivariate regression was used to analyze whether the FVH-DWI mismatch was an independent prognostic factor for exacerbation of the acute stage.Results:1.360 patients were included,there were 256 cases(71.1%)in the FVH negative group and 104 cases(28.9%)in the FVH positive group.Compared with the FVH negative group,FVH positive group had less hyperlipidemia,more atrial fibrillation,previous stroke / TIA,and higher NIHSS score on admission(P <0.05).Multivariate regression found that hyperlipidemia(OR = 0.448;95% confidence interval 0.271~0.742)and NIHSS score at admission(OR = 1.143;95% confidence interval 1.084~1.205)were independently associated with FVH positive.The proportion of M1 segment stenosis in FVH positive patients was significantly higher than that in FVH negative patients(P <0.05).The patients with FVH positive group had more severe stenosis or complete occlusion of M1 segment of middle cerebral artery than those with FVH negative group(P <0.001).In the comparison between the condition without recombination and the condition with recombination in the acute phase,only FVH positive was statistically significant(P <0.05).2.Compared with the FVH-DWI matching group,FVH-DWI mismatch group had more previous stroke / TIA patients and higher DWI-ASPECTS score(P <0.05).Multivariate logistic regression analysis,DWI-ASPECTS score(OR = 2.096;95% confidence interval 1.543-2.846)was independently related to FVH-DWI mismatch.DWI-ASPECTS predicted that the area under the ROC curve of the FVH-DWI mismatch was 0.849(95% CI: 0.775-0.922,P <0.000).FVH-DWI mismatch was not statistically significant in the acute phase without recombination and the condition plus recombination(P> 0.05).Conclusion:1.Lower blood lipid levels and higher NIHSS scores on admission were independently associated with FVH positive.FVH positive is common in severe stenosis or occlusion of M1 segment of middle cerebral artery,FVH positive is an independent risk factor for the exacerbation of the acute phase.2.DWI-ASPECTS score and FVH-DWI mismatch were independently related.FVHDWI mismatch indicates a high DWI-ASPECTS score and a small initial infarct size.FVH-DWI mismatch was not related to the exacerbation of hospitalization during the acute phase. |
