Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University Munich, Ismaninger Straße 22, 81675 Munich, Germany.
Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University Munich, Germany.
J Stroke Cerebrovasc Dis. 2020 Jul;29(7):104831. doi: 10.1016/j.jstrokecerebrovasdis.2020.104831. Epub 2020 May 11.
Previously, brain volume (BV) and intracranial cerebrospinal fluid volume (CSFV) have been investigated regarding clinical outcomes of subgroups of ischemic stroke patients. This study aimed to examine if the preexisting, preischemic BV and CSFV have an impact on good functional outcome and mortality in acute ischemic stroke (AIS) patients treated with mechanical thrombectomy (MT).
Preischemic BV, CSFV, and CSFV/Total intracranial volume (TICV)-ratio were calculated with a fully automated segmentation platform. Univariate and multivariate analyses were used to study associations.
In this retrospective study 107 subsequent AIS patients of a prospective database were included. The segmentation results of the fully automated algorithm based on non-contrast computerized tomography scans (NCCT) correlated significantly with the segmentation results obtained from 3D T1 weighted magnetic resonance images (P < 0.001). In the univariate analysis a preexisting BV (P < 0.001), preexisting CSFV (P = 0.009), and the ratio CSFV/total intracranial volume (P < 0.001) each significantly correlated with good functional outcome and mortality. However, in the multivariate regression analysis, also correcting for patient age, none of these volumes remained to correlate with these outcome parameters.
In summary, an association of BV, CSFV, and the CSFV/TICV-ratio with good functional outcome and mortality in AIS treated with MT could not be established. A fully automated segmentation algorithm based on NCCT was successfully developed in-house for calculating the volumes of interest.
此前，人们已经研究了脑容量（BV）和颅内脑脊髓液体积（CSFV）与缺血性卒中患者亚组临床结局的关系。本研究旨在探讨机械血栓切除术（MT）治疗的急性缺血性卒中（AIS）患者中，预先存在的、缺血前的 BV 和 CSFV 是否会对良好的功能结局和死亡率产生影响。
使用全自动分割平台计算缺血前 BV、CSFV 和 CSFV/总颅内体积（TICV）比值。采用单变量和多变量分析来研究相关性。
本回顾性研究纳入了前瞻性数据库中 107 例后续 AIS 患者。基于非对比计算机断层扫描（NCCT）的全自动算法的分割结果与从 3D T1 加权磁共振图像（MRI）获得的分割结果显著相关（P<0.001）。单变量分析中，预先存在的 BV（P<0.001）、预先存在的 CSFV（P=0.009）和 CSFV/总颅内体积比值（P<0.001）与良好的功能结局和死亡率均显著相关。然而，在多变量回归分析中，即使校正了患者年龄，这些体积也与这些结局参数无关。
总之，在接受 MT 治疗的 AIS 患者中，BV、CSFV 和 CSFV/TICV 比值与良好的功能结局和死亡率之间的关联无法确立。我们成功开发了一种基于 NCCT 的全自动分割算法，用于计算感兴趣的体积。
