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首页> 外文期刊>Journal of neurology >Sub-angiographic peripheral emboli in high resolution DWI after endovascular recanalization
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Sub-angiographic peripheral emboli in high resolution DWI after endovascular recanalization

机译：血管内重组后高分辨率DWI的亚血管造影外周栓塞

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Background and aim To analyze the incidence of peripheral emboli after successful mechanical thrombectomy (MT) of intracranial large vessel occlusions (LVO). Methods We performed a prospective analysis of patients with intracranial LVO who underwent successful MT and received a 1.5 T MRI including diffusion-weighted imaging (DWI) in standard- and high-resolution as well as susceptibility-weighted imaging (SWI) on the day following the intervention. Reperfusion grade was assessed on post-thrombectomy digital subtraction angiography (DSA) using the expanded thrombolysis in cerebral infarction (eTICI) scale. Punctuate DWI lesions distal to the DWI core lesion were classified as peripheral emboli. DWI lesions outside the primary affected vascular territory were classified as emboli into new territories. Additionally, SWI and post-thrombectomy DSA were analyzed and correlated to findings on DWI. Results Twenty-eight patients undergoing successful MT met the inclusion criteria. In 26/28 patients (93%), a total of 324 embolic lesions were detected in DWI representing 2.1% of the cumulated ischemic core volume. 151 peripheral emboli were detected in standard-resolution DWI, 173 additional emboli were uncovered in high-resolution DWI. Eight out of nine patients with an eTICI 3 reperfusion had embolic lesions (29 DWI lesions). 9.6% (31/324) of peripheral emboli were observed in vascular territories not affected by the LVO. SWI lesions were observed in close proximity to 10.2% (33/324) of DWI lesions. Conclusions Peripheral emboli are frequent after MT even after complete reperfusion. These emboli occur rather in the vascular territory of the occluded vessel than in other territories. A large proportion of peripheral emboli is only detected by high-resolution DWI.
机译：背景和旨在分析颅内大容器闭塞（LVO）成功机械血栓切除术（MT）后外周栓塞发生率。方法我们对患有成功MT的颅内LVO患者进行了前瞻性分析，并在当天接受了1.5吨MRI，包括标准和高分辨率的扩散加权成像（DWI）以及敏感性加权成像（SWI）之后干预。在血栓切除术后减法血管造影（DSA）上评估再灌注等级，使用脑梗塞（ETIDI）规模的扩张溶栓。 DWI核心病变远离DWI的DWI病变被归类为外周栓子。在主要受影响的血管领域之外的DWI病变被归类为栓塞进入新界。此外，SWI和血栓切除术DSA分析并与DWI的结果相关。结果28名经历成功MT的患者符合纳入标准。在26/28名患者（93％）中，在DWI中检测到总共324个栓塞病变，代表累积缺血核心体积的2.1％。在标准分辨率DWI中检测到151个外周栓子，在高分辨率DWI中发现了173个额外的栓子。八个患有氮素3再灌注的八名患者患有栓塞病变（29例DWI病变）。在血管领土不受LVO影响的情况下观察到外周栓塞9.6％（31/324）。在DWI病变的密切接近近距离观察到SWI病变。结论外周栓塞甚至在完全再灌注后常常频繁。这些栓子在遮挡船只的血管境内发生而不是在其他领土。大部分外围栓子仅通过高分辨率DWI检测。

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