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晚期窗口成像选择用于大血管封闭性中风的内血管治疗:国际调查
Thanh N Nguyen1,2, Piers Klein2, Anne Berberich3,4
1Department of Neurology Boston Medical Center Boston MA.
Stroke (Hoboken, N.J.)
|January 26, 2026
概括
对于大血管闭塞中风治疗的高级成像技术的医生决定各不相同,大多数医生认为超过20分钟的延迟是不可接受的. 对先进成像的有限访问可能会导致仅基于CT扫描的EVT决策.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 公共卫生 公共卫生
背景情况:
- 目前的中风指南建议在内血管治疗 (EVT) 前进行高级成像 (CT输液或MRI),以治疗晚期大血管封闭.
- 资源限制和访问挑战可能会阻碍遵守这些指南.
- 了解影响EVT候选人成像选择的因素至关重要.
研究的目的:
- 调查影响选择先进成像的因素,以EVT的候选人呈现后期窗口大血管封闭.
- 评估成像可用性和时间延迟对治疗决策的影响.
主要方法:
- 一项国际调查于2022年1月至5月进行.
- 该调查针对神经干预专家和其他医生,收集有关先进成像使用,治疗决策和模拟患者场景的数据.
- 分析的数据包括成像访问,时间延迟和对假设临床情况的反应.
主要成果:
- 超过1500名医生参与了调查,主要来自高收入国家的综合性中风中心.
- 70.7%的人报告了高级成像技术的常规使用,用于晚期EVT选择.
- 在综合性中风中心和高收入国家,先进的成像可用性显著更高. 如果无法进行高级成像,则有70.1%的人会根据单独的CT进行EVT. 77.7%的受访者认为先进成像的延迟超过20分钟是不可接受的.
结论:
- 对于晚期EVT候选人的医生成像决策往往偏离当前的指导方针.
- 对先进神经成像技术的有限访问影响了治疗选择,当先进的选择无法获得时,人们显然更喜欢基于CT的决定.
- 及时获得先进的成像是至关重要的,因为长时间的延迟通常被认为是不可接受的.
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