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首页> 外文期刊>Journal of Clinical Ultrasound: JCU >Exploratory analysis of estimated acoustic peak rarefaction pressure, recanalization, and outcome in the transcranial ultrasound in clinical sonothrombolysis trial
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Exploratory analysis of estimated acoustic peak rarefaction pressure, recanalization, and outcome in the transcranial ultrasound in clinical sonothrombolysis trial

机译：探索性分析声纳溶栓试验的经颅超声声峰值消除压力，再通和结局

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Purpose: Acoustic peak rarefaction pressure (APRP) is the main factor that influences ultrasound-enhanced thrombolysis. We sought to determine whether recanalization rate and functional outcomes in the Transcranial Ultrasound in Clinical SONothrombolysis (TUCSON) trial could be predicted by estimated in vivo APRP. Methods: We developed an acoustic attenuation model to estimate the in vivo APRP at the arterial occlusion site in each subject of the TUCSON trial with CT scans eligible for measurements. Variables included temporal bone thickness, depth of arterial occlusion site, and average attenuation of skin and brain tissues. Recanalization was defined as partial or complete using the Thrombolysis in Brain Infarction flow grades. Functional independence was assessed at 3 months using the modified Rankin Scale score (mRS, 0-1). Results: APRP was calculated in 20 acute ischemic stroke patients treated with sonothrombolysis (mean age, 64 ± 15 years, 65% men; median NIHSS score, 13; IQR, 6-17). The mean APRP was 30.2 ± 15.5 kPa (range, 8-68 kPa). Patients with persisting occlusion had nonsignificantly lower APRP than patients with partial or complete recanalization (25.2 ± 8.0 versus 32.3 ± 17.7 kPa; p = 0.228). Patients who were functionally independent at 3 months had nonsignificantly higher APRP than patients with worse outcome (35.1 ± 19.5 versus 25.9 ± 11.2 kPa; p = 0.217). Conclusions: Our exploratory analysis suggests a potentially important role of successful energy delivery to augment thrombolysis with 2-MHz ultrasound in acute ischemic stroke patients.
机译：目的：峰峰值稀疏压力（APRP）是影响超声增强溶栓的主要因素。我们试图确定是否可以通过估计体内APRP来预测临床超声溶栓（TUCSON）试验中经颅超声的再通率和功能结局。方法：我们开发了一种声学衰减模型，以符合条件的CT扫描评估TUCSON试验的每个受试者的动脉闭塞部位的体内APRP。变量包括颞骨厚度，动脉闭塞部位的深度以及皮肤和脑组织的平均衰减。使用脑梗塞血流溶解级别的血栓溶解术将再通定义为部分或完全。使用改良的兰金量表评分（mRS，0-1）在3个月时评估功能独立性。结果：APRP是在20例接受超声溶栓治疗的急性缺血性中风患者中计算的（平均年龄，64±15岁，男性65％; NIHSS评分中位数，13; IQR，6-17）。 APRP的平均值为30.2±15.5 kPa（范围为8-68 kPa）。持续闭塞的患者的APRP显着低于部分或完全再通的患者（25.2±8.0对32.3±17.7 kPa; p = 0.228）。在3个月内功能独立的患者的APRP显着高于转归较差的患者（35.1±19.5 vs 25.9±11.2 kPa; p = 0.217）。结论：我们的探索性分析表明，在急性缺血性中风患者中，成功地传递能量以增强2-MHz超声对血栓溶解的潜在重要作用。

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