缺血核心体积与内血管血栓切除术后的出血转变有关
概括
扩散权重成像 (DWI) 核心体积预测大血管封闭性中风后内血管血栓切除术 (EVT) 后的出血转化 (HT). DWI是评估HT风险的宝贵工具,用于在EVT后72小时内评估HT风险.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 干预心脏病学 干预心脏病学
背景情况:
- 症状性出血转化 (sHT) 是急性缺血性中风 (AIS) 治疗后的一种并发症.
- 内血管血栓切除术 (EVT) 已在AIS中显示出有效性,但缺血核心大小对出血转化 (HT) 的影响需要进一步调查.
研究的目的:
- 调查通过扩散权重成像 (DWI) 和动脉旋转标记 (ASL) 测量的缺血核心大小与EVT后HT的发展之间的关系.
- 为了确定在EVT后72小时内HT发生的基线缺血核心体积的预测值.
主要方法:
- 一项前性研究,涉及101名AIS患者,前部大血管封闭,接受EVT.
- 基线MRI包括ASL和DWI用于缺血核心体积计算.
- 多变量后勤回归和接收器运行曲线分析,以评估核心体积和HT之间的关联.
主要成果:
- 在36.6%的患者中发生了出血转化 (HT),其中16.8%的患者出现了症状性HT (sHT).
- 基线DWI体积与HT独立相关 (OR = 1.030,P = 0.009),而ASL体积没有显著意义 (P = 0.330).
- 与ASL相比,DWI模型显示了HT的优异预测能力 (c-统计,0.787).
结论:
- 基于DWI的缺血核心体积是EVT后72小时内HT的重要预测因素.
- DWI测量对接受EVT的AIS患者的治疗决策有临床有用性.
- 无论是DWI还是ASL体积都没有有效预测症状性HT (sHT).
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