The Role Of Imaging And Clinical Classification Of Cerebral Infarction In Predicting The Progressive Cerebral Infarction

Objective To investigate the role of brain imaging and Clinical Classification of cerebral infarction in predicting the progressive cerebral infarction (PCI). Methods Patients with cerebral infarction were selected in the Department of Neurology of Hefei third People’s Hospital from January 2010 to June 2014. According to the brain MRI characters, patients were divided into the following four imaging subgroups:cortical infarction, basal ganglion infarction, coronaradiata infarction and posterior infarction. Then according to the OCSP criteria, the patients studied were classified into the following 4 clinical Classification:total anterior circulation infarcts (TACI), partial anterior circulation infarcts (PACI), lacunar infarcts (LACI), and posterior circulation infarcts (POCI) based on the clinical symptoms and physical examination. Also, they were divided into PCI group and non-PCI group according to their clinical manifestations. The distribution differences of imaging and clinical classification between PCI group and non-PCI group were compared, and the correlation between the imaging classification and PCI was analyzed. Also, the risk factors of PCI was analyzed through logistic regression. Results A total of 150 patients with cerebral infarction were enrolled, which included 99 cases of non-PCI and 51 cases of PCI. According to the Brain imaging classification, there included 46 cases of cortical infarction,25 cases of coronaradiata infarction,47 cases of basal ganglion infarction and 32 cases of posterior infarction. The case of the different cerebral infarction subtypes according to OCSP criteria was as follows:total anterior circulation infarcts 7, partial anterior circulation infarcts 45, lacunar infarcts 64, and posterior circulation infarcts 34. There existed significant distribution differences of imaging subtype cerebral infarction between PCI group and non-PCI group (x2= 16.24, P= 0.001), the distribution of OCSP subtypes of cerebral infarction in the PCI and non-PCI group was also different (%2= 13.33, p= 0.004). The percent of cortical infarction, TACI and PACI were significantly higher in PCI group compared to the non-PCI group. Through logistic regression, Imaging subtypes of cerebral infarction was correlative with PCI (p= 0.002). It mainly shown that the frequency of progression in cortical infarction was increased significantly than that of other imaging subtypes of cerebral infarction (p= 0.002), even adjusted for age and blood glucose, the trend was still maintained (p= 0.014). According to the logistic regression, clinical classification cerebral infarction was also correlated to PCI (p= 0.007), which shown that frequency of progression in TACI and PACI were increased significantly compared with other clinical subtypes cerebral infarction, however, adjusted for age and blood glucose, the trend disappeared(p= 0.094). Conclusions The location of cerebral infarction was closely correlated to PCI, TACI, PACI and cortical infarction were more likely to become PCI.