机构:[1]Shenzhen Clinical Medical College of Guangzhou University of Chinese Medicine, Doctor Degree of Similar Professional Qualification, Guangzhou 51000, Guangdong, China [2]Department of Radiology, The First Hospital of Jilin University, Changchun 130000, Jilin, China [3]Department of Imaging, Shenzhen Longgang Central Hospital, Shenzhen 518116, Guangdong, China深圳市康宁医院深圳医学信息中心
Diffusion-weighted imaging lesions in intracerebral hemorrhage are related to a higher risk of recurrent intracerebral hemorrhage, cognitive damage, and mortality. However, it has been reported that the relationship between the risk of diffusion-weighted imaging lesions and intracerebral hemorrhage subtype or the possible risk factors for diffusion-weighted imaging lesions is variable. This meta-analysis was performed to evaluate this relationship. A systematic literature search up-to August 2020 was performed and 12 studies included 2815 subjects at the baseline with intracerebral hemorrhage. Odds ratio (OR) or mean difference (MD) with 95% confidence intervals (CIs) was calculated to evaluate the prognostic role of diffusion-weighted imaging lesions and intracerebral hemorrhage subtype and investigated the possible risk factors for diffusion-weighted imaging lesions using the dichotomous and continuous methods with a random or fixed-effect model. Lobar intracerebral hemorrhage was not significantly related to a higher rate of diffusion-weighted imaging lesions (OR, 1.01; 95% CI, 0.75-1.36, p = 0.94) compared to the non-lobar intracerebral hemorrhage. Also, history of diabetes mellitus (OR, 1.15; 95% CI, 0.83-1.60, p = 0.39); history of smoking (OR, 0.95; 95% CI, 0.68-1.33, p = 0.76); history of hypercholesterolemia (OR, 1.04; 95% CI, 0.73-1.48, p = 0.83); and history of ischemic stroke (OR, 1.63; 95% CI, 0.57-4.66, p = 0.36) were not significantly related to higher rate of diffusion-weighted imaging lesions compared to no history of those factors. However, the history of hypertension was significantly related to a higher rate of diffusion-weighted imaging lesions (OR, 1.33; 95% CI, 1.04-1.70, p = 0.02) compared to no history of hypertension. Also, Subjects with diffusion-weighted imaging lesions had a greater decrease in systolic pressure in the acute phase of the intracerebral hemorrhage (MD, 10.23; 95% CI, 7.41-13.06, p < 0.001) compared to without diffusion-weighted imaging lesions. Based on this meta-analysis, the history of hypertension may have an independent risk relationship with a higher rate of diffusion-weighted imaging lesions. Also, subjects with diffusion-weighted imaging lesions had a greater decrease in systolic pressure in the acute phase of the intracerebral hemorrhage compared to those without diffusion-weighted imaging lesions. This relationship forces us to recommend that identification of diffusion-weighted imaging lesions might add appreciated evidence to evaluate the progression of the underlying micro-angiopathy especially in subjects with a history of hypertension. Though further studies are needed to define the mechanisms by which these lesions may lead to cognitive damage and stroke reappearance.
第一作者机构:[1]Shenzhen Clinical Medical College of Guangzhou University of Chinese Medicine, Doctor Degree of Similar Professional Qualification, Guangzhou 51000, Guangdong, China
通讯作者:
推荐引用方式(GB/T 7714):
Li Xiang,Zhang Bei,Lou Mingwu.The relation between acute intracerebral hemorrhage and diffusion-weighted imaging lesions: a meta-analysis.[J].JOURNAL OF THROMBOSIS AND THROMBOLYSIS.2021,52(3):962-970.doi:10.1007/s11239-021-02430-6.
APA:
Li Xiang,Zhang Bei&Lou Mingwu.(2021).The relation between acute intracerebral hemorrhage and diffusion-weighted imaging lesions: a meta-analysis..JOURNAL OF THROMBOSIS AND THROMBOLYSIS,52,(3)
MLA:
Li Xiang,et al."The relation between acute intracerebral hemorrhage and diffusion-weighted imaging lesions: a meta-analysis.".JOURNAL OF THROMBOSIS AND THROMBOLYSIS 52..3(2021):962-970