在动脉旋转标签上检测出高血压与中风后内血管治疗中的最终心脏病发作量有关
Carolyn A Lomahan1, Marie Luby2, Georgios Kalarakis3
1Acute Cerebrovascular Diagnostics Unit - Stroke Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
概括
动脉旋转标记 (ASL) 在内血管治疗后的急性缺血性中风患者中比动态敏感性对比 (DSC) 更准确地检测出高血压. 来自ASL的高血压体积与最终心脏病发作体积更好地相关,这表明它有可能成为治疗点.
科学领域:
- 神经成像是一种神经成像.
- 脑卒中研究 脑卒中研究
- 脑血管生理学 脑血管生理学
背景情况:
- 接受内血管治疗 (EVT) 的急性缺血性中风 (AIS) 患者可能因大脑血液流动自调节受损而出现高血压.
- 超血,血流增加的状态,可以使用MRI perfusion技术如动态敏感度对比 (DSC) 和动脉旋转标记 (ASL) 来可视化.
研究的目的:
- 在EVT后的患者中,使用ASL相对脑血流 (rCBF) 与DSC-rCBF对比高血压的检测和体积.
- 在这些患者中调查检测到的高血压与最终心脏病发作体积 (FIV) 之间的关联.
主要方法:
- 对GUARDS队列 (NCT00009243) 的回顾性分析,包括用EVT治疗前部循环大血管封闭的患者.
- 在EVT后24小时和5天获得3TMRI与DSC-rCBF和ASL-rCBF.
- 使用Dice系数对高血压的定性和定量分析,包括使用Dice系数与FIV的体积和重叠.
主要成果:
- 在40名被纳入的患者中,ASL-rCBF检测出高血症在40%和DSC-rCBF检测出高血症在30%.
- 虽然没有统计学意义,但ASL-rCBF (85.7) 与DSC-rCBF (58.1) 相比,ASL-rCBF (85.7) 的中位数高血量较大.
- 高血压和FIV的Dice系数在ASL-rCBF (0.60) 显著高于DSC-rCBF (0.39).
结论:
- 24小时后通过ASL-rCBF测量的高血压体积显示,与DSC-rCBF相比,5天后与FIV有更强的关联.
- ASL-rCBF可能是高血压的更敏感的指标,以及它对EVT后心脏病进展的影响.
- 通过ASL发现的高血压可能成为旨在减少AIS患者心脏病发作增长的辅助疗法的目标.
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