在机械血栓切除术后的双能量计算机断层扫描中,下大脑漏与恶性脑有关
Atsushi Ogata1, Kuniaki Ogasawara2, Masashi Nishihara3
1Department of Neurosurgery, Saga University Faculty of Medicine, Saga, Japan ogata.a24@gmail.com.
Journal of neurointerventional surgery
|March 13, 2024
概括
在中风机械血栓切除术后,子arachnoid泄漏 (SAIL) 与心脏病发作体积增加和恶性脑有关. 下关节出血 (SAH) 没有显示出这种关联.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 神经外科 神经外科
背景情况:
- 双能计算断层扫描 (DE-CT) 有助于区分出血与对比性泄漏,用于急性缺血性中风 (AIS) 的机械后血栓切除术 (MT).
- 调查下下垂体出血 (SAH) 与下垂体泄漏 (SAIL) 与恶性脑 (MBE) 之间的联系对于患者的治疗结果至关重要.
研究的目的:
- 确定在MT后由DE-CT检测到的SAH和SAIL是否与MBE的发展相关.
- 评估SAH和SAIL对心脏病发作体积扩张和临床结果的影响.
主要方法:
- 对接受MT的81名前部循环AIS患者的回顾性分析.
- 在MT后立即进行DE-CT成像,以诊断SAH和SAIL.
- 在具有和没有SAH/SAIL的组之间比较手术数据,心脏病发作量 (MT前和MT后),MBE发生率和90天功能结果 (修改的兰金度表0-2).
主要成果:
- 在63%的患者中存在SAIL;在25%的患者中存在SAH.
- SAIL与MT后一天 (95毫升 vs. 29毫升) 的较大的心脏病发作量和较高的MBE发病率 (22% vs. 3%) 显著相关.
- 严重的SAIL显示与MBE有很强的关联 (OR,12.5),而SAH与MBE没有相关性.
结论:
- 在MT后立即检测到SAIL的DE-CT是心脏病扩张和MBE发展的重要预测因素.
- SAIL,而不是SAH,与不良结果有关,包括急性缺血性中风机械血栓切除术后的恶性脑.
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