Dysphasia and platelet count associated with diffusion-weighted images lesions in patients with a clinical diagnosis of transient ischemic attack

Abstract

Background Magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI) is a mandatory tool in the diagnosis of a transient ischemic attack (TIA). Many patients cannot have an MRI in time. The clinical characteristics associated with DWI positivity after TIA are of great significance for the early diagnosis and urgent intervention of TIA and cerebral infarction. This study was conducted to investigate the clinical characteristics associated with DWI lesions in TIA patients. Methods We retrospectively identified patients who met the criteria of symptom duration <24 hours for a clinical diagnosis of TIA, and then screened out 302 patients underwent DWI within 7 days of admission. The patients were divided into DWI positive and DWI negative group. The clinical characteristics including risk factors, clinical manifestation, the laboratory blood tests, the auxiliary examination and the TIA scores were compared between the two groups. We aimed to identify the clinical characteristics associated with DWI lesions using logistic regression analysis. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were calculated to compare the predictive value of various scores such as ABCD2, ABCD3, ABCD3I, Dawson score and the Diagnosis of TIA (DOT) score for DWI lesions in TIA patients. Results A total of 302 patients (mean age, 62(54,70) years; 67.2 % men) were enrolled in this study. There were 89(29.5%) patients with DWI positivity. Logistic regression analysis showed that the clinical characteristics associated with DWI lesions were dysphasia ([OR] 2.129; 95%[CI] 1.215-3.729) and platelet count ([OR] 0.993; 95%[CI] 0.988-0.999). The AUCs [95%CI] for Dawson score was 0.610[0.543-0.678] and the DOT score was 0.625[0.559-0.691]. Conclusion DWI lesions were detected in 29.5% of patients with classically defined TIA and were associated with dysphasia and platelet count. Dawson score and DOT score seem to have the predictability of DWI lesions in TIA patients.