相关实验视频

Updated: Sep 9, 2025

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

根据用于患者选择的神经成像方法,大核心中风机械血栓切除的患者结果有什么不同? 一项多中心跨国研究

Omar Alwakaa¹, Rahim Abo Kasem², Felipe Ramirez-Velandia¹

¹Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Boston, MA, 02115, USA.

Translational stroke research

|September 3, 2025

概括

对于接受内血管栓塞术的大脑中风患者,CT输液或扩散权衡成像等高级成像没有改善结果,而不是单独使用非对比CT. 非对比CT可能足以选择患者,特别是在资源有限的环境中.

科学领域:

神经学
放射学
干预心脏病学

背景情况:

选择大核心急性缺血性中风 (AIS) 患者进行内血管血栓切除 (EVT) 的最佳成像方法仍在争论中.
使用非对比CT (NCCT),CT perfusion (CTP) 和扩散权重成像 (DWI),每种都对评估心脏病核心和半阴影具有潜在的益处.

研究的目的:

通过单独使用NCCT对待的大型缺血性心脏病患者的临床结果与除NCCT外使用CTP或DWI对待患者的临床结果进行比较.
评估先进的成像方式是否影响EVT后的程序成功和功能状态.

主要方法:

对中风血栓切除和动脉瘤注册 (STAR) 数据库 (2014-2023) 的回顾性分析,包括403名前循环AIS和大核心 (ASPECTS < 6) 接受EVT的患者.
患者通过EVT前成像分层:单独使用NCCT,使用NCCT+CTP或使用NCCT+DWI.
使用倾向分数匹配 (PSM) 来创建平衡的队列来比较NCCT与CTP以及NCCT与DWI.

主要成果:

在PSM之前,功能性结局 (90天mRS0- 3),再输率 (mTICI≥2B) 和症状性内出血 (sICH) 率在各组中相似.
与NCCT (41. 3%) 和CTP (27. 8%) 相比,DWI显示了较高的mTICI≥2C率 (50. 9%). CTP组的ICH发病率最高 (44. 1%).
在 1:1 PSM 后,在 NCCT 和高级成像组之间的功能结果 (90 天 mRS 0-3),再输血 (mTICI ≥ 2C),ICH 率或sICH 率上没有显著差异.

结论:

在患有大血管封闭性AIS和低ASPECTS的患者中,仅根据NCCT或高级成像选择EVT不会显著改变程序或功能结果.
在这种群体中,NCCT可能足以进行EVT选择,特别是在资源有限的环境中.
尽管在PSM前的再输血或出血率可能存在差异,但先进的成像方法并没有显著改善患者的结果.

关键词:

阿尔伯塔州中风计划早期计算机断层扫描 (ASPECT) 分数血管内血栓切除术大血管封闭倾向性得分匹配一次中风成功的重新道化

更多相关视频

Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli

Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli

Published on: September 25, 2016

Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping

Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping

Published on: September 25, 2019

相关概念视频

Imaging Studies VII: Vascular Imaging

Imaging Studies VII: Vascular Imaging

DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...

Imaging Studies for Cardiovascular System IV: CMRI

Imaging Studies for Cardiovascular System IV: CMRI

Cardiovascular magnetic resonance imaging, or CMRI, is a non-invasive diagnostic test that employs a magnetic field and radiofrequency waves to create precise images of the heart and arteries. It provides comprehensive information about cardiac anatomy, function, perfusion, and tissue characterization without ionizing radiation.IndicationsCMRI diagnoses various heart conditions, including tissue damage from heart attacks, ischemic heart disease, myocarditis, aortic issues (tears, aneurysms,...

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...