Jiang Liang, Su Hao-Bo, Zhang Ying-Dong, Zhou Jun-Shan, Geng Wen, Chen Huiyou, Xu Quan, Yin Xindao, Chen Yu-Chen
Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Oncotarget. 2017 Sep 19;8(46):81529-81537. doi: 10.18632/oncotarget.21081. eCollection 2017 Oct 6.
Collateral vessels were considered to be related with outcome in endovascular-treated acute ischemic stroke patients. This study aimed to evaluate whether the collateral vessels on magnetic resonance angiography (MRA) could predict the clinical outcome.
Acute stroke patients with internal carotid artery or middle cerebral artery occlusion within 6 hours of symptom onset were included. All patients underwent MRI and received endovascular treatment. The collateral circulations at the Sylvian fissure and the leptomeningeal convexity were evaluated. The preoperative and postoperative infarct volume was measured. The clinical outcome was evaluated by mRS score at 3 months after stroke.
Of 55 patients, Cases with insufficient collateral circulation at the Sylvian fissure and leptomeningeal convexity showed that the NIHSS score at arrival and preoperative infarct volume were significantly lower in mRS score of 0-2 (both < 0.05) than mRS score of 3-6. Multivariate testing revealed age and collateral status at the leptomeningeal convexity were independent of the clinical outcome at 3 months after stroke (odds ratio (95% confidence interval): 1.094 (1.025-1.168); 9.542 (1.812-50.245) respectively). The change of infarct volume in the group with mRS score of 0-2 was smaller than that with mRS score of 3-6. While multivariate logistic models showed that postoperative infarct volume was non-significant in predicting the clinical outcome after stroke.
The extent of collateral circulation at the leptomeningeal convexity may be useful for predicting the functional recovery while the relationship between postoperative infarct volume and clinical outcome still requires for further study.
在接受血管内治疗的急性缺血性脑卒中患者中,侧支血管被认为与预后相关。本研究旨在评估磁共振血管造影(MRA)上的侧支血管是否能预测临床预后。
纳入症状发作6小时内出现颈内动脉或大脑中动脉闭塞的急性脑卒中患者。所有患者均接受了MRI检查并接受了血管内治疗。评估了大脑外侧裂和软脑膜凸面的侧支循环。测量了术前和术后的梗死体积。在脑卒中后3个月通过改良Rankin量表(mRS)评分评估临床预后。
55例患者中,大脑外侧裂和软脑膜凸面侧支循环不足的病例显示,mRS评分为0 - 2分的患者入院时的美国国立卫生研究院卒中量表(NIHSS)评分和术前梗死体积均显著低于mRS评分为3 - 6分的患者(均P < 0.05)。多因素检验显示,年龄和软脑膜凸面的侧支状态与脑卒中后3个月的临床预后独立相关(优势比(95%置信区间):分别为1.094(1.025 - 1.168);9.542(1.812 - 50.245))。mRS评分为0 - 2分的组梗死体积变化小于mRS评分为3 - 6分的组。而多因素逻辑模型显示,术后梗死体积在预测脑卒中后的临床预后方面无显著意义。
软脑膜凸面的侧支循环程度可能有助于预测功能恢复,而术后梗死体积与临床预后之间的关系仍需进一步研究。