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低的表面扩散系数值与大缺血核心的内血管治疗后的出血转变有关

Takeru Umemura¹, Yuko Tanaka², Toru Kurokawa²

¹Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan. takeru.u115@gmail.com.

|June 18, 2025

概括

缺血核心的低明显扩散系数 (ADC) 预测大缺血中风内血管治疗 (EVT) 后的出血转变 (HT). 低于480 × 10^-6 mm²/s的峰值ADC值表明HT的风险更高.

科学领域:

神经学神经学
放射学放射学是指放射学
干预心脏病学干预心脏病学

背景情况:

内血管治疗 (EVT) 对大缺血性中风至关重要,但会带来出血转变 (HT) 的风险.
在扩散权重成像 (DWI) 上的明显扩散系数 (ADC) 评估缺血压力和组织活力.
低阿尔伯塔州中风计划DWI早期计算机断层扫描得分 (ASPECTS) 显示出严重的缺血损伤.

研究的目的:

调查大缺血性中风EVT后低明显扩散系数 (ADC) 和出血转换 (HT) 之间的关联.
为了确定低ADC,结合低ASPECTS-DWI得分,预测HT.
为了确定与HT风险相关的ADC的预测值.

主要方法:

对经过成功EVT的急性大缺血性中风 (ASPECTS-DWI ≤ 5) 患者进行了回顾性队列研究.
在缺血核心和DWI损伤体积内评估峰值ADC.
对有和没有EVT后HTT的患者进行比较,以确定与低ADC和其他因素的关联.

主要成果:

在78名患者中,25名 (32%) 患者经历了EVT后的HT,其中17名 (22%) 患上了帕伦基马性血液瘤.
在HT和非HT组之间发现了峰值ADC (p=0.0036) 和发病至重化时间 (p=0.0151) 的显著差异.
多变量分析显示,低峰ADC是HT的显著预测因素 (OR,0.839;p=0.018),HT发展的值为<480 × 10-6 mm2 / s.

结论:

缺血核心的低峰ADC与大缺血中风EVT后的出血转换 (HT) 有显著的关联.
已识别的高峰ADC值为<480 × 10^-6mm²/s,可以帮助预测HT风险.
使用ADC评估缺血核心对于确认EVT适用性和管理HT风险至关重要.

关键词:

表面扩散系数的明显扩散系数扩散权重成像技术的使用.血管内治疗血管内治疗血液变化的出血转化大的缺血核心.较大的缺血性中风.

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