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Clinical Article
Clinical and imaging features and prognostic factors of acute ischemic stroke in patients with Trousseau's syndrome
SONG Ziyang  DAI Yao  WU Zhiwei  MA Mengya  LIU Yuanqing  FENG Mengmeng  DAI Hui 

SONG Z Y, DAI Y, WU Z W, et al. Clinical and imaging features and prognostic factors of acute ischemic stroke in patients with Trousseau's syndrome[J]. Chin J Magn Reson Imaging, 2023, 14(8): 40-44, 57. DOI:10.12015/issn.1674-8034.2023.08.006.

[Abstract] Objective To analyze clinical and imaging features of acute ischemic stroke (AIS) in patients with Trousseau's syndrome, and to explore the prognostic factors.Materials and Methods A retrospective analysis was conducted on 65 patients with malignant tumor complicated with Trousseau's syndrome and their clinical and imaging features were summarized. Based on their modified Rankin Scale (mRS) score, patients were divided into good prognosis group (mRS<3, n=35) and poor prognosis group (mRS≥3, n=30) . The features of the two groups were compared using independent sample t-test, Mann-Whitney U test or χ2 test. Indices with statistical significance in univariate binary logistic regression analysis were included in multivariate binary logistic regression analysis for prognostic analysis. Besides, patients were divided into asymptomatic cerebral infarction group (n=25) and symptomatic cerebral infarction group (n=40), and multivariate binary logistic regression analysis was performed to explore the independent risk factors of symptomatic cerebral infarction.Results Patients with Trousseau's syndrome showed increased level of D-dimer, small and numerous infarcts in different vascular supply areas. Compared with the good prognosis group, the poor prognosis group showed higher proportion of three territory sign in MRI, greater number of cerebral infarctions, higher National Institutes of Health Stroke Scale (NIHSS) score at admission, higher level of D-dimer, lower level of hemoglobin (Hb) and red blood cell count (P<0.05). Multivariate analysis showed that increased D-dimer (OR=5.094, 95% CI: 1.726-15.039) was an independent prognostic factor for poor prognosis in such patients. Infarct volume was an independent risk factor for symptomatic cerebral infarction (OR=1.227, 95% CI: 1.025-1.047).Conclusions Patients with AIS complicated with Trousseau's syndrome were characterized by hypercoagulation status and small and numerous infarcts in different vascular supply areas; increased D-dimer level is an independent prognostic risk factor and infarct volume was an independent risk factor for symptomatic cerebral infarction.
[Keywords] Trousseau syndrome;magnetic resonance imaging;malignant tumor;acute ischemic stroke;prognosis;D-dimer

SONG Ziyang   DAI Yao   WU Zhiwei   MA Mengya   LIU Yuanqing   FENG Mengmeng   DAI Hui*  

Department of Radiology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China

Corresponding author: Dai H, E-mail:

Conflicts of interest   None.

ACKNOWLEDGMENTS National Natural Science Foundation of China (No. 81971573).
Received  2023-01-03
Accepted  2023-07-27
DOI: 10.12015/issn.1674-8034.2023.08.006
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