Department of neurology, The First Affiliated Hospital of Soochow University, No.899, Pinghai Road, Suzhou, 215000, Jiangsu, China.
Neurol Sci. 2020 Jun;41(6):1451-1458. doi: 10.1007/s10072-020-04296-7. Epub 2020 Feb 21.
Acute ischemic stroke leads to serious long-term disability and high mortality, especially in patients with large-vessel occlusive strokes. Nowadays, endovascular therapy is considered as an alternative treatment for these patients. Several studies have used thrombus characteristics based on non-contrast computed tomography (NCCT) and computed tomography angiography (CTA) to predict prognosis in ischemic stroke. We conducted a systematic review to identify potential imaging predictive factors for successful recanalization and improved clinical outcome after endovascular therapy in patients with large-vessel occlusion (LVO) in anterior arterial circulation.
The PubMed databases were searched for related studies reported between September 18, 2009, and September 18, 2019.
We selected 11 studies on revascularization and 12 studies on clinical outcome. Patients with thrombus of higher Hounsfield unit (HU), shorter length, higher clot burden score, and increased thrombus permeability may achieve higher recanalization and improved clinical outcome, but the matter is still under debate.
Imaging of thrombus can be used as an aseessment tool to predict the outcomes and it needs further studies in the future.
急性缺血性脑卒中可导致严重的长期残疾和高死亡率，尤其是在大血管闭塞性脑卒中患者中。如今，血管内治疗被认为是这些患者的一种替代治疗方法。几项研究已经使用基于非对比 CT（NCCT）和 CT 血管造影（CTA）的血栓特征来预测缺血性脑卒中患者血管内治疗后的预后。我们进行了一项系统评价，以确定前循环大血管闭塞（LVO）患者血管内治疗后成功再通和临床结局改善的潜在影像学预测因素。
检索了 2009 年 9 月 18 日至 2019 年 9 月 18 日之间发表的相关研究的 PubMed 数据库。
我们选择了 11 项关于再通的研究和 12 项关于临床结局的研究。血栓的亨斯菲尔德单位（HU）值较高、长度较短、血栓负荷评分较高和血栓通透性增加的患者可能实现更高的再通率和改善的临床结局，但这一问题仍存在争议。
血栓的影像学表现可用作评估工具来预测预后，未来还需要进一步研究。
