Neuroradiology · 2025
Prominence of deep medullary veins associated with the risk of stroke in unilateral chronic internal carotid artery occlusion patients.
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Liang Na, Di Wei, Li Zhiwei, Liu Xiaoling, Cheng Xiansong, Liu Sheng, Hu Jun
Аннотация
PURPOSE: To clarify the relationship between deep medullary veins (DMV) and risk of post-discharge stroke in chronic internal carotid artery occlusion (CICAO) patients.
METHODS: Hospitalized patients were divided into CICAO patients and control group without cerebral artery occlusion. SWI assessed DMV prominence in both cerebral hemispheres on a 0-3 scale. If the DMV scores of both hemispheres were consistent, DWV was not prominent (DMV-). Otherwise, DWV was prominent (DMV+) in the higher score hemisphere. In DMV + patients with CICAO, if the DMV score in the ipsilateral hemisphere of CICAO was higher than the contralateral hemisphere, DMV + was DMVi, otherwise, DMV + was DMVc.
RESULTS: 110 unilateral CICAO patients and 75 control group patients were finally enrolled. 89CICAO patients and 5 control group patients were DMV+. In CICAO patients, 54 were DMVi patients and 35 were DMVc patients. Binary logistic regression analysis showed that CICAO was the independent risk factor of DMV+ (OR: 75.23; 95%CI :25.58-240.07; P < 0.001). Compared with DMVc patients, DMVi patients had a lower proportion of simultaneous primary and secondary collaterals activation(P = 0.034), decreased perfusion in the CICAO ipsilateral hemisphere (P < 0.001) and higher DMV scores in the prominent hemisphere (P = 0.012). Cox regression showed that the risk of stroke events post discharge in DMVi patients was higher than that in DMVc patients (HR: 4.68; 95%CI: 1.02-21.50; P = 0.047).
CONCLUSION: CICAO is an independent risk factor for DMV. The collateral circulation and cerebral perfusion are related to DMVc. DMVc predictes a lower risk of stroke in CICAO patients post discharge.
METHODS: Hospitalized patients were divided into CICAO patients and control group without cerebral artery occlusion. SWI assessed DMV prominence in both cerebral hemispheres on a 0-3 scale. If the DMV scores of both hemispheres were consistent, DWV was not prominent (DMV-). Otherwise, DWV was prominent (DMV+) in the higher score hemisphere. In DMV + patients with CICAO, if the DMV score in the ipsilateral hemisphere of CICAO was higher than the contralateral hemisphere, DMV + was DMVi, otherwise, DMV + was DMVc.
RESULTS: 110 unilateral CICAO patients and 75 control group patients were finally enrolled. 89CICAO patients and 5 control group patients were DMV+. In CICAO patients, 54 were DMVi patients and 35 were DMVc patients. Binary logistic regression analysis showed that CICAO was the independent risk factor of DMV+ (OR: 75.23; 95%CI :25.58-240.07; P < 0.001). Compared with DMVc patients, DMVi patients had a lower proportion of simultaneous primary and secondary collaterals activation(P = 0.034), decreased perfusion in the CICAO ipsilateral hemisphere (P < 0.001) and higher DMV scores in the prominent hemisphere (P = 0.012). Cox regression showed that the risk of stroke events post discharge in DMVi patients was higher than that in DMVc patients (HR: 4.68; 95%CI: 1.02-21.50; P = 0.047).
CONCLUSION: CICAO is an independent risk factor for DMV. The collateral circulation and cerebral perfusion are related to DMVc. DMVc predictes a lower risk of stroke in CICAO patients post discharge.