Suppr超能文献

[基于动态CT血管造影的侧支血流评估与急性基底动脉闭塞所致卒中患者预后的关系]

[Relationship between dynamic CT angiography-based collateral flow evaluation and outcome of patients with stroke induced by acute basilar artery occlusion].

作者信息

Lai Zhenzhen, Zhang Sheng, Zhong Genlong, Zhang Xiaocheng, Chen Qingmeng, Lou Min

机构信息

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.

出版信息

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.

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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%).

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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%)。

结论

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。

相似文献

1
2
Prognostic Value of Different Imaging Scores Based on CTA in Endovascular Treatment of Acute Basilar Artery Occlusion.
J Coll Physicians Surg Pak. 2022 Nov;32(11):1392-1397. doi: 10.29271/jcpsp.2022.11.1392.
3
Computed Tomography Perfusion Deficit Volumes Predict Functional Outcome in Patients With Basilar Artery Occlusion.
Stroke. 2021 Jun;52(6):2016-2023. doi: 10.1161/STROKEAHA.120.032924. Epub 2021 May 5.
4
Collateral flow predicts outcome after basilar artery occlusion: The posterior circulation collateral score.
Int J Stroke. 2016 Oct;11(7):768-75. doi: 10.1177/1747493016641951. Epub 2016 Mar 25.
5
[Collateral score based on CT perfusion can predict the prognosis of patients with anterior circulation ischemic stroke after thrombectomy].
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2017 Jul 25;46(4):377-383. doi: 10.3785/j.issn.1008-9292.2017.08.06.
6
Collateral Scores and Outcomes after Endovascular Treatment for Basilar Artery Occlusion.
Cerebrovasc Dis. 2019;47(5-6):285-290. doi: 10.1159/000502083. Epub 2019 Aug 21.
7
The Basilar Artery on Computed Tomography Angiography Prognostic Score for Basilar Artery Occlusion.
Stroke. 2017 Mar;48(3):631-637. doi: 10.1161/STROKEAHA.116.015492. Epub 2017 Feb 22.
8
Cerebral blood volume lesion extent predicts functional outcome in patients with vertebral and basilar artery occlusion.
Int J Stroke. 2019 Jul;14(5):540-547. doi: 10.1177/1747493017744465. Epub 2017 Nov 21.
9
The Basilar Artery on Computed Tomography Angiography Score for Acute Basilar Artery Occlusion Treated with Mechanical Thrombectomy.
J Stroke Cerebrovasc Dis. 2018 Jun;27(6):1570-1574. doi: 10.1016/j.jstrokecerebrovasdis.2018.01.007. Epub 2018 Feb 13.
10
Mechanical Thrombectomy in Basilar Artery Occlusion: Clinical Outcomes Related to Posterior Circulation Collateral Score.
Stroke. 2020 Jul;51(7):2045-2050. doi: 10.1161/STROKEAHA.120.029861. Epub 2020 Jun 17.

本文引用的文献

1
Safety and Outcome of Intra-Arterial Treatment for Basilar Artery Occlusion.
JAMA Neurol. 2016 Oct 1;73(10):1225-1230. doi: 10.1001/jamaneurol.2016.1408.
2
Collateral flow predicts outcome after basilar artery occlusion: The posterior circulation collateral score.
Int J Stroke. 2016 Oct;11(7):768-75. doi: 10.1177/1747493016641951. Epub 2016 Mar 25.
3
Time window for recanalization in basilar artery occlusion: Speculative synthesis.
Neurology. 2015 Nov 17;85(20):1806-15. doi: 10.1212/WNL.0000000000002129.
4
Posterior circulation CT angiography collaterals predict outcome of endovascular acute ischemic stroke therapy for basilar artery occlusion.
J Neurointerv Surg. 2016 Aug;8(8):783-6. doi: 10.1136/neurintsurg-2015-011883. Epub 2015 Aug 17.
5
Endovascular revascularization for basilar artery occlusion.
Interv Neurol. 2015 Jan;3(1):31-40. doi: 10.1159/000368968.
6
Endovascular therapy for ischemic stroke with perfusion-imaging selection.
N Engl J Med. 2015 Mar 12;372(11):1009-18. doi: 10.1056/NEJMoa1414792. Epub 2015 Feb 11.
7
"Imaging Evaluation of Collaterals in the Brain: Physiology and Clinical Translation".
Curr Radiol Rep. 2014 Jan;2(1):29. doi: 10.1007/s40134-013-0029-5.
8
Recanalization of acute basilar artery occlusion improves outcomes: a meta-analysis.
J Neurointerv Surg. 2015 Dec;7(12):868-74. doi: 10.1136/neurintsurg-2014-011418. Epub 2014 Sep 30.
9
Recommendations on angiographic revascularization grading standards for acute ischemic stroke: a consensus statement.
Stroke. 2013 Sep;44(9):2650-63. doi: 10.1161/STROKEAHA.113.001972. Epub 2013 Aug 6.
10
Current treatment of basilar artery occlusion.
Ann N Y Acad Sci. 2012 Sep;1268:35-44. doi: 10.1111/j.1749-6632.2012.06687.x.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验