血栓切除术后的即时CT变化预测了症状性出血转变
Shang-Jung Yang1, Yueh-Hsun Lu2,3,4, Yi-Chen Huang2
1Department of Radiology, En Chu Kong Hospital, New Taipei City, Taiwan, ROC.
Journal of the Chinese Medical Association : JCMA
|July 7, 2023
概括
机械血栓切除术后在非对比CT上对比积累可以预测急性缺血性中风患者的症状出血. 在皮层区域的最大霍恩斯菲尔德单位超过100表示高风险.
科学领域:
- 神经辐射学神经辐射学
- 脑卒中成像 脑卒中成像
- 干预神经病学 干预神经病学
背景情况:
- 在机械血栓切除术 (MT) 后评估症状出血的风险对于急性缺血性中风管理至关重要.
- 在MT后立即进行的非对比计算断层扫描 (CT) 可以揭示对比积累,这是一个潜在的成像生物标志物.
研究的目的:
- 评估立即MT后非对比CT对比积累的预后值,以预测症状出血.
- 确定对比度积累的模式和程度是否与症状出血风险相关.
主要方法:
- 对101名接受MT治疗的急性缺血性中风患者的回顾性分析.
- 根据症状出血,无症状出血或没有出血来对患者进行分类.
- 在使用ROC曲线,灵敏度,特异性和赔率比率的皮质区域分析对比度积累模式和最大Hounsfield单位 (HU).
主要成果:
- 对比度积累与所有类型的出血转变有显著的关联 (p < 0.01).
- 在有症状出血的患者中,对比度积累的皮质参与更为频繁 (p < 0.01).
- 在皮层区域最大HU>100显示出高预测值 (AUC=0.887,灵敏度=77.8%,特异性=95.7%,OR=77.0) 的症状出血.
结论:
- 与最大HU> 100相反积累的皮层参与是症状出血后内血管再输治疗的强有力的预测因素.
- 这种成像发现可以帮助进行风险分层和临床决策,对于中风患者进行MT.
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