CT血管图案预测,在急性缺血性中风中,动脉的伪闭塞会导致急性缺血性中风
Sayooja Sachithanandan1, Harikrishnan Ramachandran1, E R Jayadevan2
1Comprehensive Stroke Care Program, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Annals of Indian Academy of Neurology
|March 18, 2024
概括
计算机断层扫描血管造影 (CTA) 可以在急性缺血性中风 (AIS) 患者中区分心动脉伪闭塞 (PO) 和真实闭塞 (TO). 鼻子图案和CTA上的逐渐对比度下降表明PO,有助于内血管血栓切除术 (EVT) 规划.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 血管外科 血管外科
背景情况:
- 在急性缺血性中风 (AIS) 中选择患者进行内血管血栓切除术 (EVT) 时,区分带伪闭塞 (PO) 和真正的闭塞 (TO) 是至关重要的.
- 精确的区分影响了EVT程序的可行性和成功率.
研究的目的:
- 识别计算机断层扫描血管图 (CTA) 模式,使PO从TO区分开来.
- 分析PO和TO的EVT后的成功再通道化率.
主要方法:
- 经过EVT (2014-2021) 的急性缺血性中风和近道内动脉 (ICA) 阻塞患者的回顾性审查.
- 对CTA模式的分类 (鼻子,圆顶,平面) 和与PO/TO的数字减去血管学 (DSA) 发现的相关性.
- 分析PO与TO组中成功的再道化率.
主要成果:
- 16名患者患有ICA PO,8名患有TO. 在PO中,CTA孔图案的频率显著增加 (87.5%与25%相比,P=0.005).
- 在TO中,CTA平面模式更常见 (50%对12%,P=0.005). 在CTA上逐渐下降的对比度是PO特有的 (85.7%与0%,P=0.05).
- 在PO (81.25%) 和TO (62.5%) 组 (P=0.362) 之间,成功的再通道化率没有显著差异.
结论:
- 中枢动脉动脉发现,特别是鼻子图案和近端ICA的逐渐对比度下降,表明了带伪闭塞.
- 通过CTA识别PO有助于规划干预策略和对急性缺血性中风的患者预后.
- CTA是区分动脉闭塞类型的宝贵工具,指导EVT决策.
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