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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Thrombus Features in Hyperacute Ischemic Stroke: A Perspective on Using Length and Density Evaluation
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Thrombus Features in Hyperacute Ischemic Stroke: A Perspective on Using Length and Density Evaluation

机译：超急性缺血性卒中的血栓特征：使用长度和密度评估的观点

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Background: More insights in the etiopathogenesis of thrombi could be helpful in the treatment of patients with acute ischemic stroke (AIS). One of the most confident and early imaging findings of stroke includes arterial hyperdensity. The purpose of this study was to determine whether thrombi's density and length would be useful for predicting their origin. Methods: We evaluated 68 consecutive patients with AIS to correlate the presence of thrombi and their imaging features with the stroke subtype. Results: After excluding patients with small-artery occlusion mechanism and undetermined and other causes, the stroke etiologic subtypes were large-artery atherosclerosis (LAA) in 59.0% of the patients, cardioembolism in 31.0%, and cervical artery dissection (CAD) in 10.0%. CAD more often caused thrombi with the longest length and highest attenuation, while thrombi that originated from the LAA had the smallest length and lowest attenuation. The mean Hounsfield unit (HU) values of all thrombi (with and without hyperdensity) on noncontrast computed tomography were 62.4 (50.0-70.0) in CAD, 53.8 (42.0-65.0) in cardioembolism, and 48.6 (27.0-65.0) in LAA. The length measurements were 28.5 mm (12.0-52.0) in CAD, 13.7 mm (5.0-31.0) in cardioembolism, and 10.8 mm (3.0-25.0) in the LAA subtype. The minimum cutoff value of 60 HU and a length greater than 20 mm were able to discriminate the CAD thrombi with an accuracy of 86.8% and 92.6%, respectively. Conclusion: Our study findings show how important thrombus analysis is in patients with AIS. Thrombus analysis can allow early suspicion of CAD before dedicated imaging of the cervical arteries is performed.
机译：背景：更多有关血栓的病因的见解可能有助于治疗急性缺血性中风（AIS）患者。中风最有信心和早期影像学表现之一包括动脉高密度。这项研究的目的是确定血栓的密度和长度对于预测血栓的起源是否有用。方法：我们评估了68例连续的AIS患者，以将血栓的存在及其影像学特征与中风亚型相关联。结果：剔除具有小动脉闭塞机制且原因不明的患者后，中风病因学亚型为大动脉粥样硬化（LAA）59.0％，心脏栓塞31.0％，颈动脉夹层（CAD）10.0 ％。 CAD更常导致最长的血栓和最大的衰减，而源自LAA的血栓的长度最小和衰减最小。在非对比计算机断层扫描上，所有血栓（有或没有高密度）的平均Hounsfield单位（HU）值在CAD中为62.4（50.0-70.0），在心脏栓塞术中为53.8（42.0-65.0），在LAA中为48.6（27.0-65.0）。长度测量值在CAD中为28.5毫米（12.0-52.0），在心脏栓塞术中为13.7毫米（5.0-31.0），在LAA亚型中为10.8毫米（3.0-25.0）。最小截止值60 HU和长度大于20 mm能够区分CAD血栓，准确度分别为86.8％和92.6％。结论：我们的研究结果表明，血栓分析在AIS患者中的重要性。血栓分析可以在进行颈动脉专门成像之前及早怀疑CAD。

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