| Objective:To investigate the incidence of asymmetrical cortical vein sign(ACVS)in patients with acute ischemic stroke(AIS)and its correlation with stroke etiology,infarct size and early functional improvement.Methods:Consecutive patients with acute anterior circulation ischemic stroke were collected from the Department of Neurology,the Third Hospital of Hebei Medical University.Diffusion weighted imaging(DWI),susceptibility weighted imaging(SWI),magnetic resonance angiography(MRA)and transcranial doppler(TCD)were performed in all patients.The etiological classification of AIS,the size and extent of infarct,and the imaging information of ACVS were evaluated.The National Institute of Health Stroke Scale(NIHSS)score was used to evaluate the neurological impairment at baseline and discharge.The early functional improvement was defined as the NIHSS score at discharge decreased by more than 4 points compared with the baseline NIHSS score.The patients were divided into ACVS(+)group and ACVS(-)group.The differences of demographic,clinical and imaging information between the two groups were compared,and the predictive value of each index for ACVS(+)was evaluated by Logistic regression analysis.Key observations:1.Whether the existence of ACVS is related to the etiological classification of stroke and the size of infarction;2.The relationship between early functional improvement and ACVS.Results:A total of 164 AIS patients were included,including 104 males(63.4%)and 60 females(36.6%),with an average age of(63.25 ± 12.6)years.There were 34 cases(20.7%)in ACVS(+)group and 130 cases(79.3%)in ACVS(-)group.Comparing the demographic,past medical history and other indicators between the two groups,it was found that patients in ACVS(+)group were more likely to have lung disease(26.5% vs 10.8%,P=0.027),and more likely to have large atherosclerotic stroke(91.2% vs 66.9%,P=0.047),the infarct volume was larger(2.2 vs 0.6,P=0.022),and DWI-ASPECTS was lower(P=0.014).There was no significant difference in other baseline data such as age,gender,past medical history,blood examination indexes at admission,baseline NIHSS score and NIHSS score at discharge(P>0.05).After adjusting for the interference factors,Logistic regression analysis showed that pulmonary disease(OR = 3.149,95% CI 1.037～9.559;P=0.043)and infarct volume(OR = 1.047,95% CI 1.006～1.091;P=0.026)were independent predictors of ACVS positive.In addition,patients with early functional improvement(NIHSS score reduction ≥ 4)were more common in ACVS(+)group(17.6% vs 3.8%,P=0.011;OR = 8.652,95% CI1.220～61.355,P=0.031).Conclusion:ACVS is more common in patients with large atherosclerotic stroke,which is related to the history of pulmonary disease and larger infarct volume in stroke patients,and has a certain predictive value for good early neurological improvement.Therefore,the ACVS signs of SWI can be used to guide clinicians to make etiological classification and early prognosis judgment of stroke. |
