Meta-analysis Of Associations Between Dwi Manifestations And The Prognosis Of Tia

Objective: To study the value of DWI in the prognosis of patients with transient ischemic attack.Methods: More than one thousand articles published in 2000-2009 were retrieved from China National Knowledge Infrastructure (CNKI),Pubmed, Cochrane Library (CL) and Foreign Medical Journal Full-Text Service (FMJS). Of them, 13 articles were chosen. Meta analysis was performed.Results: In the 13 articles, there were 1485 patients included, of which 530 cases were with DWI abnormalities. Of all the patients, the 96 cases were stroke , the 81 cases were recurrent TIA, the 384 cases were duration of symptoms>60min,the 243 cases were speech disturbance, the 313 cases were motor deficits, and the 79 cases were sensory inattention. The study results indicate that the prognosis of TIA is correlated with DWI manifestations. The stroke morbidity in DWI(+) group was all higher than those in DWI(-) group (OR=9.13,95%Cl: 5.06-16.45,P<0.00001) by fix-effect model analysis. The morbidity was different between DWI(+) group and DWI(-) group in the recurrent TIA (OR=1.69,95%Cl:1.05-2.73,P=0.03). But by random-effect model analysis, there was no significant difference in the recurrent TIA between DWI(+) group and DWI(-) group (OR=2.04,95%Cl:0.94-4.40,P=0.07). Because of the heterogeneity , the random-effect model analysis was accepted in the studies of the DWI manifestations with duration of symptoms >60min , speech disturbance and motor deficits patients after TIA. The duration of symptoms>60min morbidity in DWI(+) group was higher than that in DWI(-) group(OR=2.65,95%Cl:1.59-4.42,P=0.0002). The speech disturbance morbidity in DWI(+) group and DWI(-) group was no significant difference (OR=1.39,95%Cl:0.80-2.41,P=0.24). The motor deficits morbidity in DWI(+) group were lower than those in DWI(-) group (OR=1.71,95%Cl:0.63-4.70,P=0.29).Conclusion: TIA with DWI abnormalities is associated with a higher rate of stroke, and recurrent TIA, duration of symptoms>60min, speech disturbance, motor deficits,sensory inattention are correlated with DWI manifestations. The data should be prudently treated because of the heterogeneity in some studies.