高低 perfusion 强度比独立地与大缺血核心中风的非常糟糕的结果有关
Vivek Yedavalli1, Hamza Adel Salim2,3, Dhairya A Lakhani2
1Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA. vyedava1@jhmi.edu.
Clinical neuroradiology
|October 7, 2024
概括
低输血强度比率 (HIR) 和入院NIHSS预测大缺血核心中风患者治疗内血管血栓切除术 (EVT) 的结果不佳. 较高的HIR和NIHSS得分表明90天结果非常差的可能性更大.
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:
- 内血管血栓切除术 (EVT) 对大缺血核心中风有效,但许多患者仍然有不良结果 (90天mRS 5-6).
- 需要预测性成像生物标志物来识别高风险的患者,在EVT后出现不良结果.
- 低 perfusion 强度比 (HIR) 是一个潜在的预后成像参数.
研究的目的:
- 在接受EVT的大型缺血性核心中风的患者中调查HIR和非常差的结果 (90天mRS5-6) 之间的关联.
- 在这个患者群体中评估HIR作为预后成像参数.
主要方法:
- 在102名急性缺血性中风和大血管闭塞 (AIS-LVO) 患者的多中心回顾性队列研究中.
- 患者的ASPECTS值为5或更低,并接受治疗前输液成像,以计算HIR.
- 主要结局是非常糟糕的结局,定义为90天的mRS为5-6.
主要成果:
- 57.8%的患者 (59/102) 经历了非常糟糕的结果.
- 较高的入院国家卫生研究院中风量表 (NIHSS) 分数独立地与非常差的结果相关 (aOR 1.224).
- 更高的HIR独立地与非常糟糕的结果相关 (aOR每0.1个增量变化,1.34).
结论:
- 入院NIHSS和HIR是用EVT治疗的大缺血核心中风患者非常糟糕的结果的独立预测因素.
- 这些发现强调了担保状况和 perfusion 成像在预测结果中的重要性.
- HIR可能有助于对大型核心中风患者的分拣和管理.
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