Ritter Martin A, Poeplau Tobias, Schaefer Anne, Kloska Stephan P, Dziewas Rainer, Ringelstein E Bernd, Heindel Walter, Nabavi Darius G
Department of Neurology, University of Münster, Münster, Germany.
Cerebrovasc Dis. 2006;22(5-6):362-7. doi: 10.1159/000094852. Epub 2006 Aug 3.
To investigate whether acute phase intracranial CT angiography (CTA) independently predicts infarction and functional outcome in ischemic stroke.
Hundred and fifty-one consecutive patients with acute (<12 h) ischemic stroke who received intracranial CTA were investigated. Stroke severity on admission was determined using the National Institute of Health Stroke Scale (NIHSS). Reconstructed CTAs were investigated for relevant pathology. Follow-up imaging was performed 24-48 h after admission. Functional outcome was assessed after 3 months using the modified Rankin scale. Single factor and multiple logistic regression analyses were performed to predict infarction and dependency (modified Rankin scale > or = 3) on follow-up.
Median NIHSS on admission was 10 (IQR 3-14). Out of the 151 patients, 61 (40%) had pathological CTA findings. Infarction was demonstrated in 60/61 patients (98%) with and in 67/90 patients (74%) without vessel pathology. Presence of infarction on follow-up imaging and dependency at 3 months were correlated with pathological CTA findings on admission in single factor analysis (each p < 0.001). After adjustment for age (> or =/<65 years), NIHSS (> or =/<10), sex, therapy, and time to presentation (> or =/<3 h), only NIHSS > or = 10 on admission was predictive of dependency at follow-up (p < 0.001).
Pathological CTA findings in the acute phase of ischemic stroke do not independently predict a poor outcome at 3 months after acute stroke.
探讨急性期颅内CT血管造影（CTA）能否独立预测缺血性卒中的梗死情况及功能转归。
对151例连续的急性（<12小时）缺血性卒中且接受颅内CTA检查的患者进行研究。入院时使用美国国立卫生研究院卒中量表（NIHSS）确定卒中严重程度。对重建的CTA进行相关病理检查。入院后24 - 48小时进行随访成像。3个月后使用改良Rankin量表评估功能转归。进行单因素和多因素逻辑回归分析以预测随访时的梗死情况及依赖程度（改良Rankin量表>或= 3）。
入院时NIHSS中位数为10（四分位间距3 - 14）。151例患者中，61例（40%）有CTA病理表现。有血管病理表现的61例患者中有60例（98%）出现梗死，无血管病理表现的90例患者中有67例（74%）出现梗死。单因素分析显示，随访成像时梗死的出现及3个月时的依赖程度与入院时CTA病理表现相关（均p < 0.001）。在调整年龄（>或=/<65岁）、NIHSS（>或=/<10）、性别、治疗及就诊时间（>或=/<3小时）后，仅入院时NIHSS >或= 10可预测随访时的依赖程度（p < 0.001）。
缺血性卒中急性期的CTA病理表现不能独立预测急性卒中后3个月的不良转归。
