在急性中风中,在基线MRI上过度估计缺血核心
M A McArthur1, E Tavakkol1, M Bahr-Hosseini2
1Department of Radiological Sciences, University of California, Los Angeles, Los Angeles, USA.
概括
幽灵核心或MRI上高估的缺血核心在急性缺血中风 (AIS) 患者中很少见,使用严格的扩散值. 然而,它发生在近4%的超急性患者中,影响治疗决策.
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:
- 在急性缺血性中风 (AIS) 中,MRI-DWI 上缺血核心的高估主要观察到在扩散减少不严重的区域.
- 这项研究研究了在AIS患者中使用受限制的扩散值对成功再输血的缺血核心过高估计.
研究的目的:
- 在AIS患者的治疗前MRI上评估缺血核心高估的可能性,即使使用受限制的明显扩散系数 (ADC) 值 (≤620 × 10-6 mm2/s).
- 确定在成功实现再输血的AIS患者中"幽灵核心" (过高估计的缺血核心) 的发生率和特征.
主要方法:
- 对AIS患者进行预治疗MRI,成功再注血和随访MRI以确定最终心脏病发作体积的回顾性分析.
- 预处理缺血核心和最终心脏病发作体积的计算,将"幽灵核心"定义为高于10毫升的高估值.
- 基线临床,人口和治疗相关因素的审查.
主要成果:
- 在156名患者中,共有6名患者 (3.8%) 在基线MRI上显示过高估计的缺血核心体积 (幽灵核心),平均过高估计为65.6毫升.
- 三名患者的治疗前核心估计量>70毫升,而他们的最终心脏病发作体积<70毫升.
- 所有六名患有幽灵核心的患者在症状发作120分钟内进行了成像 (中位数:65分钟).
结论:
- 幽灵核心或缺血核心高估是罕见的,但在使用严重ADC值 (≤620 × 10-6 mm2/s) 时,大约在25名超急性AIS患者中发生1例.
- 这种现象仅限于症状出现后120分钟内成像的患者.
- 对于精确的治疗决策和AIS管理中的临床试验入学,对幽灵核心的认识至关重要.
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