Tuğba İlkem KURTOĞLU ÖZÇAĞLAYAN, Demet ÖZKARAMANLI GÜR, Ömer ÖZÇAĞLAYAN, Birol TOPCU, Aysun ÜNAL

Ciddi Koroner Arter Hastalığında Sessiz Beyin İskemisini Değerlendirmede Tarama Aracı Olarak Kranial Manyetik Rezonans Görüntüleme: Klinik Tabanlı Bir Çalışma

Amaç: Nörolojik bulgu göstermeyen iskemik değişiklikler ve enfarktlar olarak tanımlanan sessiz beyin iskemisi (SBI), kötü sağ kalımın bilinen bir göstergesidir. Manyetik rezonans görüntüleme (MRG), SBI ve mikroanjiopatik iskemik hastalığa karşılık gelen beyaz madde hiperintensitelerini göstermede yararlı bir yöntemdir. Bu çalışmada SBI, beyaz madde lezyonları ile koroner arter hastalığı (KAH) arasındaki ilişkiyi araştırmak ve SBI'nın olası belirleyicilerini belirlemek amaçlanmıştır. Gereç ve Yöntemler: Koroner anjiyografi yapılan toplam 10640 hasta retrospektif olarak taranarak 6 ay içerisinde müteakip olarak kranial MRG ile değerlendirilmiş 312 hasta belirlendi. KAH ciddiyeti Gensini skoru ile tespit edildi ve MRG’ler SBI varlığı ile Fazekas skoru ile ölçülen beyaz madde hiperintensiteleri açısından değerlendirildi. Bunun sonucunda SBI olan 58 ve SBI olmayan 254 hasta, SBI ve SBI olmayan hasta gruplarını oluşturdu. Bulgular: SBI olan hastalar, SBI olmayan hastalardan anlamlı şekilde daha yaşlı ve daha yüksek prevalansta erkek cinsiyette idi. SBI grubunda hem Gensini hem de Fazekas skorları daha yüksekti (p

Anahtar Kelimeler:

Beyin iskemisi, koroner anjiyografi, koroner arter hastalığı, manyetik rezonans görüntüleme, inme

Cranial Magnetic Resonance Imaging as a Screening Tool for Evaluation of Silent Brain Ischemia in Severe Coronary Artery Disease: A Clinical Based Study

Aim: Silent brain ischemia (SBI), defined as ischemic changes and infarcts without neurologic signs, is an established marker of poor survival. Magnetic resonance imaging (MRI) is useful to define SBI and white matter hyperintensities that correspond to microangipathic ischemic disease. This study aimed to investigate the relationship among SBI, white matter lesions and the extent of coronary artery disease (CAD), and to determine possible predictors of SBI. Material and Methods: A total 10640 patients who underwent coronary angiography were retrospectively screened to reveal 312 patients who had been evaluated with a subsequent cranial MRI within 6 months. CAD severity was established with Gensini score and MRIs were evaluated to determine presence of SBI and white matter hyperintensities scored by Fazekas. Finally, 58 patients with SBI and 254 without SBI consisted SBI and non-SBI groups. Results: Patients with SBI were significantly older with higher prevalence of male gender than the non-SBI patients. Both Gensini and Fazekas scores were higher in SBI-group (p

Keywords:

Brain ischemia, coronary angiography, coronary artery disease, magnetic resonance imaging, stroke,

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