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首页> 外文期刊>AJNR. American journal of neuroradiology >Perfusion CT in patients with acute ischemic stroke treated with intra-arterial thrombolysis: predictive value of infarct core size on clinical outcome.
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Perfusion CT in patients with acute ischemic stroke treated with intra-arterial thrombolysis: predictive value of infarct core size on clinical outcome.

机译：动脉内溶栓治疗急性缺血性脑卒中患者的灌注CT：梗塞核心大小对临床结局的预测价值。

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BACKGROUND AND PURPOSE: A potential role of perfusion CT (PCT) in selecting patients with stroke for reperfusion therapies has been recently advocated. The purpose of the study was to assess the reliability of PCT in predicting clinical outcome of patients with acute ischemic stroke treated with intra-arterial thrombolysis (IAT). MATERIALS AND METHODS: Twenty-seven patients with acute hemispheric ischemic stroke were investigated with PCT and treated with IAT between 3 and 6 hours of stroke onset. The infarct core was outlined on cerebral blood volume (CBV) maps by using accepted viability thresholds. The penumbra was defined as time-to-peak (TTP)-CBV mismatch. Clinical outcome was assessed by modified Rankin Scale (mRS) scores at 3 months and dichotomized into favorable (mRS score, 0-2) and unfavorable (mRS score, 3-6). Data were retrospectively analyzed by multiple regression to identify predictors of clinical outcome among the following variables: age, sex, National Institutes of Health Stroke Scalescore, serum glucose level, thrombolytic agent, infarct core and mismatch size, collateral circulation, time to recanalization, and recanalization rate after IAT. RESULTS: Patients with favorable outcome had smaller cores (P = .03), increased mismatch ratios (P = .03), smaller final infarct sizes (P < .01), higher recanalization rates (P = .03), and reduced infarct growth rates (P < .01), compared with patients with unfavorable outcome. The core size was the strongest predictor of clinical outcome in an "all subset" model search (P = .01; 0.96 point increase in mRS score per any increment of 1 SD; 95% confidence interval, +0.17 to +1.75). CONCLUSIONS: PCT is a reliable tool for the identification of irreversibly damaged brain tissue and for the prediction of clinical outcome of patients with acute stroke treated with IAT.
机译：背景与目的：最近提倡了灌注CT（PCT）在选择中风患者进行再灌注治疗中的潜在作用。这项研究的目的是评估PCT在预测接受动脉内溶栓治疗（IAT）的急性缺血性中风患者的临床结局方面的可靠性。材料与方法：对27例急性半球缺血性卒中患者进行了PCT检查，并在卒中发作3至6小时之间接受了IAT治疗。通过使用公认的生存力阈值，在脑血容量（CBV）图上勾勒出梗塞核心。半影被定义为峰值时间（TTP）-CBV不匹配。在3个月时通过改良的Rankin量表（mRS）评分评估临床结局，并分为良好（mRS评分，0-2）和不利（mRS评分，3-6）。通过多元回归分析对数据进行回顾性分析，以确定以下变量之间的临床结果预测因素：年龄，性别，美国国立卫生研究院卒中量表，血清葡萄糖水平，溶栓剂，梗塞核心和错配大小，侧支循环，再通血的时间以及IAT后的再通率。结果：预后良好的患者核心较小（P = .03），错配比增加（P = .03），最终梗死面积更小（P <.01），再通率更高（P = .03），梗死减少与有不良结果的患者相比，增长率（P <.01）。在“所有子集”模型搜索中，核心大小是临床结果的最强预测指标（P = 0.01;每增加1 SD，mRS得分增加0.96点; 95％置信区间为+0.17至+1.75）。结论：PCT是一种可靠的工具，可用于识别不可逆转的受损脑组织，并预测接受IAT治疗的急性中风患者的临床结局。

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