在急性缺血性中风中缺血核心的临床评估使用修改的扩散加权成像-阿尔伯塔中风程序 早期计算机断层扫描通过缺血可逆性得分 使用信号强度
Daisuke Izawa1, Hiroyuki Matsumoto1, Hirokazu Nishiyama1
1Department of Neurological Surgery, Kishiwada Tokushukai Hospital, Kishiwada, Osaka, Japan.
Journal of neuroendovascular therapy
|July 28, 2023
概括
从扩散加权成像 (DWI) 高信号强度 (HSI) 病变中减去可逆性缺血性损伤 (RIL),可以提高缺血性中风核心的诊断准确度. 在DWI中,HSI比率的1.4可能表明可逆性,与大血管封闭 (LVO) 治疗后更好的临床结果相关.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 医疗成像医学成像
背景情况:
- 由于大血管封闭 (LVO) 引起的急性缺血性中风需要早期的再通道化.
- 扩散加权成像 (DWI) 高信号强度 (HSI) 病变表明中风的严重程度.
- 识别可逆性缺血病变 (RIL) 对于治疗评估至关重要.
研究的目的:
- 调查DWI上从HSI病变中减去RIL是否可以提高缺血核心的诊断准确性.
- 确定HSI比率的诊断效用,以确定急性缺血性中风患者的RIL.
主要方法:
- 对35名急性缺血性中风患者的回顾性分析,前部循环LVO患者接受了血栓切除术.
- 计算缺血性病变的HSI比率,并与相反的正常组织进行比较.
- 基于从初始DWI到术后DWI的HSI比率改善的RIL定义;ROC分析以确定切断值.
主要成果:
- 分析了127个缺血病变;RIL显示HSI比重明显低于不可逆转的缺血病变 (p <0.0001).
- 在57%的患者中,HSI比率1.4的截止值确定了RIL.
- 患有RIL的患者 (HSI比率<1.4) 的术后NIHSS得分明显较低,NIHSS改善更大.
结论:
- 在手术前的DWI中,HSI比率<1.4可能表明缺血性可逆性.
- HSI比率方法在评估缺血核心和预测临床结果方面具有潜在的实用性.
- 这种方法可以帮助优化急性缺血性中风的治疗策略.
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