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血栓切除术在缺血性中风患者的大核心但小缺血变化在非增强计算机断层扫描

Gabriel Broocks^1,2, Helge Kniep¹, Rosalie McDonough^1,3

¹Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

International journal of stroke : official journal of the International Stroke Society

|April 26, 2024

概括

机械血栓切除术 (MT) 有利于患有大缺血核心和高阿尔伯塔中风计划早期CT评分 (ASPECTS) 评分的患者. 重化与核心体积的高估有关,这可能解释了MT.

科学领域:

神经成像在中风管理中的神经成像
干预神经病学干预神经病学
脑血管疾病脑血管疾病

背景情况:

阿尔伯塔州中风计划早期CT评分 (ASPECTS) 指导机械血栓切除术 (MT) 的选择.
计算机断层扫描输液 (CTP) 成像评估缺血半阴影,但可以显示大量的核心体积,尽管高方面.
ASPECTS和CTP之间的差异可能会影响MT治疗决策.

研究的目的:

为了调查血管再通道化结果是否在MT患者之间有所不同,这些患者具有较大的缺血核心 (核心体积>50毫升),但高ASPECTS (≥6) 与具有较小核心和高ASPECTS的患者相比.
为了确定重新道化是否与缺血核心体积的高估有关.

主要方法:

用MT治疗的缺血性中风患者的观察研究.
90天后的功能独立 (修改的兰金尺度0-2) 是主要的终点.
核心高估被定义为CTP衍生核心体积超过最终心脏病发作体积.
倾向性得分匹配 (PSM) 和多变量逻辑回归分析了重新道化 (eTICI ≥ 2b) 对结果和核心高估的影响.

主要成果:

在630名ASPECTS≥6的患者中,有91人 (14.4%) 患有大缺血核心.
在PSM后,再通道治疗没有显示出与核心较小 (ASPECTS ≥ 6) 患者相比,核心较大 (ASPECTS ≥ 6) 患者的治疗效果有显著差异.
重化 (aOR: 3.46) 和更高的核心体积 (aOR: 1.03) 与核心高估值有显著的关联.

结论:

在具有ASPECTS ≥6的患者中,核心体积在重新道化后没有显著改变结果.
重灌和更大的核心体积与核心高估有关.
核心高估可能解释了MT在患有大缺血核心但在非增强CT上看似轻微变化的患者中观察到的治疗效果.

关键词:

一次性中风,中风.计算机断层扫描 (CT) 是一种计算机断层扫描.perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion perfusion 这是一个非常重要的方法,它可以让一个人觉得自己是个好的人,而不是一个好的人,而不是一个好的人.进行血栓切除术 (thrombectomy).

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