Lai Zhenzhen, Zhang Sheng, Zhong Genlong, Zhang Xiaocheng, Chen Qingmeng, Lou Min
Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
Department of Neurology, Tiantai People's Hospital of Zhejiang Province, Tiantai 317200, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2017 Jul 25;46(4):371-376. doi: 10.3785/j.issn.1008-9292.2017.08.05.
To evaluate the collateral flow in patients with ischemic stroke due to acute basilar artery occlusion by dynamic CT angiography and to predict the outcome after reperfusion therapy.
Forty-five patients with stroke due to acute basilar artery occlusion undergoing reperfusion treatment in the Second Affiliated Hospital of Zhejiang University School of Medicine during January 2012 and August 2016 were retrospectively reviewed. Univariate and binary logistic regression model were used to identify the independent predictors of patient's outcome, and the receiver operating characteristic (ROC) curve was used to determine the optimal threshold of the posterior circulation collateral score (PC-CS) in predicting the prognosis of the patients.
Binary logistic regression analysis indicated that the baseline National Institutes of Health Stroke Scale (NIHSS) score (=0.886, 95% :0.802-0.979, <0.05) and PC-CS (=1.962, 95%:1.026-3.752, <0.05) were independent predictors of patient's outcome, and PC-CS 4.5 was the optimal threshold (AUC:0.837, sensitivity of 68.2%, specificity of 87.0%).
Dynamic CT angiography based on CT perfusion imaging can be used to evaluate collaterals in posterior circulation, and to predict clinical outcome after reperfusion therapy in patients with acute basilar artery occlusion.
通过动态CT血管造影评估急性基底动脉闭塞所致缺血性卒中患者的侧支循环,并预测再灌注治疗后的结局。
回顾性分析2012年1月至2016年8月在浙江大学医学院附属第二医院接受再灌注治疗的45例急性基底动脉闭塞所致卒中患者。采用单因素和二元逻辑回归模型确定患者结局的独立预测因素,并使用受试者工作特征(ROC)曲线确定后循环侧支循环评分(PC-CS)预测患者预后的最佳阈值。
二元逻辑回归分析表明,基线美国国立卫生研究院卒中量表(NIHSS)评分(=0.886,95%可信区间:0.802-0.979,P<0.05)和PC-CS(=1.962,95%可信区间:1.026-3.752,P<0.05)是患者结局的独立预测因素,PC-CS 4.5是最佳阈值(AUC:0.837,敏感性为68.2%,特异性为87.0%)。
基于CT灌注成像的动态CT血管造影可用于评估后循环侧支循环,并预测急性基底动脉闭塞患者再灌注治疗后的临床结局。