Combining Various Vascular Assessment Tools For The Value Of The Cerebral Infarction Etiology Classification

Objective: to study the high-resolution magnetic resonance(HRMRI) combining regular vascular assessment tools for the value of the cerebral infarction etiology classification.Method: continuously collecting the patients with acute cerebral infarction who were treated in department of neurology of Fujian Medical University affiliated union hospital from 2015.07 to 2016.02.to conform to the inclusion criteria of 80 cases of acute cerebral infarction patients with conventional vascular assessment first, which as the conventional group, 40 patients of them then to carry on high-resolution magnetic resonance, which as the high resolution magnetic resonance group. according to the CISS classification standard,conducting etiology classification of the two groups, and comparing the difference of CISS classification in conventional group and high resolution magnetic resonance group, and compared before and after etiology in high-resolution mri classification of distribution, diversity and consistency, cause of high-resolution mri group in addition to TOAST classification, high resolution magnetic resonance group of the differences of two causes parting with consistency.Results: here were 80 patients with acute cerebral infarction, high-resolution mri group included 40 patients with acute cerebral infarction, CISS classification of high-resolution mri group, large-artery atherosclerosis for 23 cases(57.5%),cardiogen-ic stroke for 9 cases(22.5%),perforators artery disease for 5 cases(12.5%),other etiologies for 0 cases and unknown etiology for 3 cases(7.5%);TOAST classification of high resolution mri group,large-artery atherosclerosis for 13(32.5%), cardiac embolism for 11 cases(27.5%), Small artery occlusion type/lacunar cerebral infarction for 9 cases(22.5%),stroke of other determined etiology for 0 cases of stroke(0%) and stroke of undetermined etiology for 7 cases(17.5%).Conventional group include 80 patients, CISS classification of conventional group, large-artery atherosclerosis for 27 cases(33.75%),cardiogenic stroke for 23cases(28.75%),perforators artery disease for 21 cases(26.25%),other etiologies for 0 cases and unknown etiology for 9 cases(11.25%).the subtypes distribution of CISS classification was no significant difference in high-resolution mri group and conventional group(p> 0.05), LAA subtypes in high-resolution mri group was obviously higher than that of conventional group(p< 0.05). CISS classification and TOAST classification etiology distribution had significant difference in high-resolution mri group(p< 0.05), two kinds of classification of cardiogenic stroke etiology diagnosis consistency was very good, the artery atherosclerosis etiology diagnosis of medium consistency.The distribution before HRMRI examination had a significant difference with the distribution after HRMRI examination in HRMRI group(p< 0.01), LAA subtype before HRMRI examination is significantly lower than that after HRMRI examination(p< 0.05), PAD subtype before HRMRI examination was significantly higher than that after HRMRI examination(p< 0.05), cardiogenic stroke subtype and undetermined etiology subtype before HRMRI examination had good consistency with that after HRMRI examination, the artery atherosclerosis subtype and perforators artery lesions subtype before HRMRI examination had medium consistency with that after HRMRI examination.Heart disease, lipid metabolic disorder, smoking history had statistically significant differences in subtypes distribution of cerebral infarction patients(p< 0.05).Conclusion: Using high-resolution mri help cerebral infarction of CISS etiology classification, especially for large artery atherosclerosis subtype checked out.Using high-resolution magnetic resonance, compared with the TOAST classification, CISS classification improves the artery atherosclerosis subtype diagnosis rate and overall the diagnosis of etiology.CISS parting with TOAST classification of medium consistency, can promote clinical work.Heart disease is the most common cardiac stroke, clinical encounters with patients at high risk of heart disease in the first consider cardiac stroke.