在急性缺血性中风患者中预测心脏病增长的基于输血的附带因素:多中心比较分析
Mark McArthur1, Mona Asghariahmadabad1, Michael Thomas1
1From the Department of Radiological Sciences (M.M., E.T., A.I.), Neurology (M.B.-H., D.S.L.), David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA; Department of Radiology and Biomedical Imaging (M.M., M.A., M.T., C.W., S.S., K.N.), University of California, San Francisco, CA, USA; Department of Radiology (A.A.S., M.M.-B.), University of Washington, Seattle, WA, USA; Department of Radiology (M.M.-B.), University of Alabama at Birmingham, Birmingham, AL, USA; Department of Radiology (V.Y.), Johns Hopkins University, Baltimore, Maryland and Department of Neurology and Neurosurgery (H.S., J.M.), Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
整合脑血量 (CBV) 的输血指数,如rCBV-Index和PCI,可以比基于延迟的HIR更好地预测急性缺血性中风 (AIS) 患者的心脏病增长. 这些发现有助于AIS的治疗决策和预后.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 医疗成像医学成像
背景情况:
- 在急性缺血性中风 (AIS) 患者中,强大的附带证据与心脏病进展的减少有关.
- 基于 perfusion 的担保指数,包括 hypoperfusion 强度比 (HIR),相对脑血体积指数 (rCBV-Index) 和 perfusion 担保指数 (PCI),用于评估 AIS 中的担保状态.
- 这些指标在AIS中成功转血后预测心脏病增长的诊断性能需要进一步评估.
研究的目的:
- 评估和比较基于输液的附带指数的诊断能力,以预测AIS患者在再输液后的心脏病增长.
- 为了确定附带指数与心脏病发作增长之间的关联.
- 确定AIS中心脏病增长的独立预测因子.
主要方法:
- 一项回顾性多中心研究包括前部循环大血管封闭患者,接受预治疗输液成像,成功再输液 (mTICI ≥2b),并在24-48小时内进行随访MRI.
- 实质性心脏病发作增长被定义为与基线缺血核心体积相比,最终心脏病发作体积≥10毫升.
- 基于输血的附带指数 (HIR,rCBV-Index,PCI) 被计算出来,并使用单变量和多变量逻辑回归分析了它们与心脏病增长的关联.
主要成果:
- 在116名患者中,50%的患者经历了心脏病发作增长 (≥10毫升).
- 根据PCI和rCBV-Index的判断,较差的抵押品与心脏病增长有显著的关联 (p<0.01),而HIR则没有 (p=0.83).
- 确定了心脏病发作增长的独立预测因素是基线NIHSS,rCBV-Index和PCI.
结论:
- 基于输血的附带指数,包括大脑血液体积 (rCBV-Index和PCI),在预测AIS患者实质性心脏病增长方面表现优于基于延迟的HIR.
- 这些发现表明,rCBV-Index和PCI是AIS治疗决策,患者转移和预后的有价值工具.
- 进一步的研究可能会完善这些指数在临床实践中的应用.
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