通过视觉评估的ASPECTS定义的大缺血核心可以预测相对准确的功能结果,在6-24小时窗口中与自动CT输液相比较准确
Tolga D Dittrich1,2,3, Anh Nguyen3,4, Peter B Sporns3,4
1Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
European stroke journal
|October 7, 2024
概括
视觉评估的非对比CT阿尔伯塔中风计划早期CT分数 (ASPECTS) 与自动CT输液 (aCTP) 在预测大血管阻塞中风患者的结果方面同样有效. 这一发现支持使用ASPECTS用于选择前部循环大血管封闭 (aLVO) 的治疗.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 脑卒中医学 脑卒中医学
背景情况:
- 自动CT输液 (aCTP) 是选择前循环大血管封闭 (aLVO) 患者进行内血管治疗 (EVT) 的标准.
- 对功能性结果进行视觉评估的非对比CT阿尔伯塔中风计划早期CT得分 (ASPECTS) 与aCTP的预测准确性尚未得到充分证实.
研究的目的:
- 为了比较视觉评估的ASPECTS和aCTP在预测aLVO患者有利的功能结果中的准确性.
- 评估这些成像方法与中风后3个月的功能结果之间的关联.
主要方法:
- 来自瑞士中风注册表 (2014-2021) 的210名aLVO患者的回顾性分析,接受了EVT或最佳医疗治疗.
- 在非对比CT上视觉评估ASPECTS;在aCTP上评估缺血核心体积.
- 后勤回归和ROC曲线分析用于比较有利结果的预测准确性 (修改的兰金尺度[mRS] 0-2) 在3个月后.
主要成果:
- 视觉评估的ASPECTS,但不是aCTP核心体积,与有利的功能结果显著相关 (acOR1.85,P=0.001).
- 对于两种方法的ROC分析显示,诊断准确度相似 (ASPECTS:0.80与aCTP核心:0.79).
结论:
- 视觉评估的ASPECTS在预测aLVO患者的功能结果方面,与自动CT输液核心体积的准确性相当,甚至更高.
- 在LVO中风管理中,ASPECTS仍然是指导治疗决策的宝贵工具.
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