在基线计算机断层扫描成像上皮质缩预测了急性缺血性中风内血管治疗的患者的临床结果
Gianluca Brugnara1,2, Adrian Engel1,3, Jessica Jesser1
1Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
European radiology
|August 15, 2023
概括
在CT扫描中,与年龄相关的白质变化和皮质缩是中风治疗后临床结果的强有力的预测因素. 这些发现可以改善患者对机械血栓切除术的选择.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 脑卒中医学 脑卒中医学
背景情况:
- 经过急性缺血性中风和大血管封闭后的临床结果取决于超出再通道程度的因素.
- 小血管疾病和皮质缩是潜在的促成因素.
研究的目的:
- 评估小血管疾病和皮质缩对临床结果的影响.
- 为了评估这些因素,在大量患者队列中使用本地脑计算机断层扫描 (NCCT) 来评估这些因素.
主要方法:
- 分析了接受内血管治疗 (EVT) 的1103名中脑动脉封闭患者.
- 通过视觉评估,NCCT数据对与年龄相关的白质变化 (ARWMC) 和大脑缩进行了评估.
- 使用回归和机器学习模型来确定预测相关性.
主要成果:
- 结果乐观的患者具有较低的先前存在的大脑恶化指标 (p < 0.001).
- 两种ARWMC (p < 0.05) 和皮质缩 (p < 0.001) 独立预测了90天的临床结果.
- 这些因素提高了机器学习模型的预测准确性,缩是前五大预测因素.
结论:
- 基于NCCT的皮质缩和ARWMC得分是EVT后临床结果的强大,独立的预测因素.
- 对这些CT标记物的视觉评估可以增强结果预测模型,帮助患者选择进行血栓切除术.
相关概念视频
Imaging Studies III: Computed Tomography
28
DefinitionComputed Tomography (CT) of the genitourinary (GU) tract is a non-invasive imaging modality that utilizes X-rays and computer processing to generate detailed cross-sectional images of the urinary system, encompassing the kidneys, ureters, bladder, and adjacent structures such as the adrenal glands.PurposeCT scans of the GU tract serve several diagnostic and therapeutic purposes, including:Diagnosis of Urinary Tract Diseases: Detects kidney stones, tumors, cysts, and congenital...
28
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
39
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
39
Imaging Studies for Cardiovascular System V: CT
42
Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
42
Imaging Studies VII: Vascular Imaging
31
DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
31
Aneurysm II: Clinical Manifestations and Diagnostic Studies
10
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
10
Acute Coronary Syndrome III: Diagnostic Studies
10
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
10


