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Julia Emde¹, Romy Baumgart¹, Niklas Langguth¹

¹Department of Neurology, University Hospital Giessen-Marburg Location Giessen, Giessen, Germany.

Frontiers in stroke

|January 16, 2026

概括

无对比CT (NCCT) 可能足以在延长时间窗口内选择缺血性中风患者接受静脉血栓缓解疗法 (IVT),即使没有高级成像. 这种方法似乎是安全和有效的,通过避免治疗延迟,可能改善患者的治疗结果.

科学领域:

神经学神经学
紧急医疗紧急医疗
放射学放射学是指放射学

背景情况:

静脉血栓缓解疗法 (IVT) 在4.5小时内有效治疗缺血性中风.
先进的成像 (MRI,CTP) 可以在4.5小时以后确定合适的患者,但并不总是可用.
无对比CT (NCCT) 是广泛可用的,可以帮助在延长或未知的时间窗口中选择患者进行IVT.

研究的目的:

对在未知或延长的时间窗口中出现的缺血性中风患者使用NCCT进行IVT选择的疗效和安全性进行审查.
评估NCCT是否可以替代这些特定患者群体的高级成像.

主要方法:

对基于NCCT的IVT策略的当前文献和数据的审查.
对回顾性研究和注册数据 (例如,TRUST-CT) 的分析.
检查元分析和即将到来的试验结果 (例如,TWIST试验).

主要成果:

在扩展窗口中基于NCCT的IVT的数据有限,但表明安全性和有效性.
在没有高级成像检查的患者中,TRUST-CT注册表显示IVT的结果比没有IVT的结果更好.
分析表明,与标准4.5小时窗口相比,NCCT选择的症状性脑内出血 (sICH) 发生率相似.

结论:

在延长或未知的时间窗口中,NCCT可能足以选择缺血性中风患者进行IVT.
先进的神经成像无法使用,不应阻止患者接受IVT或其他回治疗.
目前的数据支持基于NCCT的IVT的安全性,尽管需要进一步的研究来确定其在所有情况下与高级成像技术的不劣.

关键词:

阿尔伯塔州中风计划早期CT得分 (ASPECTS)先进的成像成像技术提供了先进的成像.延长时间窗口影像成像技术影像成像技术静脉内血栓溶解 (IVT) 是一种缺血性中风中风没有对比度的CTCT.

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