Transcranial Color-coded Sonography Combined With ABCD~3I Score In Predicting Cerebral Apoplexy After Transient Ischemic Attack

Objective:To investigate the predictive value of transcranial color-coded sonography(TCCS)combined with ABCD3 1 score in cerebral apoplexy after 7 days of transient ischemic attack(TIA).To evaluate the agreement between TCCS and computerized tomography angiography(CTA)or digital substraction angiography(DSA)for the diagnosis of steno-occlusive lesion of the symptomatic large intracranial artery in patients with recent TIAMethods:TCCS and computerized tomography angiography(CTA)or digital substraction angiography(DSA)were performed in 108 patients.Among them,93 patients with CTA and 15 patients with DSA.By CTA or DSA as the inspection standard,used method of Kappa test comparing TCCS and CTA or DSA to check out the consistency of intracranial vascular stenosis in patients with TIA.108 patients were stratified according to ABCD3 I score.The incidence of cerebral apoplexy of TIA patients in 7 days was analyzed in terms of risk stratification and the relationship between the degree of artery stenosis by TCCS positive results and incidence of cerebral apoplexy in patients with TIA was also explored.The ability of TCCS combined with ABCD3 I stratification model and ABCD3 I stratification model to predict the risk of stroke after TIA were compared and analyzed.Results:TCCS and CTA or DSA had high consistency in the detection rate of intracranial vascular disease in patients with TIA.The lowest Kappa value was found in the posterior cerebral artery.(Kappa=0.622>0.6).The incidence of cerebral apoplexy in TIA patients with severe stenosis and occlusion was significantly higher than that in those with normal or mild stenosis in 7 days(P<0.05).There were statistically significant differences in the degree of intracranial vascular stenosis between the low-risk,medium-risk and high-risk groups of ABCD31 stratification(X2=31.587,p=0.000),there was a statistically significant difference between the low and high risk group(p=0.000),there was also a statistically difference between the medium and high risk group(p=0.001);the results showed that the higher the ABCD3I score,the greater the risk of moderate and above stenosis.There were statistically significant differences in the risk of stroke among the three groups of ABCD3 I stratification:low risk group,medium risk group and high risk group(x2=11.4334,p=0.0033),there was a statistically significant difference between the low and high risk group(p=0.0096),there was also a statistically difference between the medium and high risk group(p=0.0212);the incidence of cerebral apoplexy within 7 days after TIA was significantly higher in high risk group than that in low and medium group.The areas under the ROC curve of ABCD31 stratified model and TCCS combined with ABCD31 stratified prediction of cerebral apoplexy were 0.743 and 0.907,the latter area was greater than the former.Conclusion:1.TCCS combined with ABCD3I score has a high predictive value for short-term cerebral apoplexy after TIA.2..Severe intracranial vascular stenosis or occlusion at the lesion side can be regarded as an independent risk factor of ABCD3I score to predicte cerebral apoplexy after TIA.3.TCCS has a high accuracy in detecting the lesion side intracranial vascular lesions in TIA patients.