Department of Neurology, 12249Southern Illinois University School of Medicine, Springfield, IL, USA.
Department of Neurology, University of Iowa Medical Center, Iowa City, IA, USA.
Int J Stroke. 2022 Jan;17(1):101-108. doi: 10.1177/1747493021991972. Epub 2021 Feb 8.
The hyperdense middle cerebral artery sign on computed tomography indicates proximal middle cerebral artery occlusion. Recent reports suggest an association between the hyperdense sign and successful reperfusion. The prognostic value of the hyperdense middle cerebral artery sign in patients receiving mechanical thrombectomy has not been extensively studied.
Our study aims to evaluate the association between the hyperdense middle cerebral artery sign and functional outcome in patients with M1 occlusions that had undergone mechanical thrombectomy.
We conducted a single-center retrospective observational cohort study of 102 consecutive patients presenting with acute M1 occlusions that had undergone mechanical thrombectomy. Patients were stratified into cohorts based on the presence of hyperdense middle cerebral artery sign visually assessed on computed tomography by two readers. The outcomes of interests were functional disability measured by the ordinal Modified Rankin Scale (mRS) at 90 days, mortality, reperfusion status and hemorrhagic conversion.
Out of the 102 patients with M1 occlusions, 71 had hyperdense middle cerebral artery sign. There was no significant difference between the cohorts in age, baseline mRS, NIHSS, ASPECTS, and time to reperfusion. The absence of hyperdense middle cerebral artery sign was associated with increased odds of being dependent or dying (higher mRS) (OR: 3.24, 95% CI: 1.30-8.06, = 0.011) after adjusting for other significant predictors, including age, female sex, hypertension, presenting serum glucose, ASPECTS, CTA collateral score, and successful reperfusion.
The absence of hyperdense middle cerebral artery sign is associated with worse functional outcome in patients presenting with M1 occlusions undergoing thrombectomy.
计算机断层扫描（CT）上的高密度大脑中动脉征表明大脑中动脉近端闭塞。最近的报告表明，高密度征与再通成功之间存在关联。接受机械血栓切除术的患者中，高密度大脑中动脉征的预后价值尚未得到广泛研究。
我们的研究旨在评估接受机械血栓切除术的 M1 闭塞患者中，高密度大脑中动脉征与功能结局之间的关系。
我们进行了一项单中心回顾性观察队列研究，纳入了 102 例接受机械血栓切除术的急性 M1 闭塞患者。根据两位读者在 CT 上目测评估的高密度大脑中动脉征的存在情况，将患者分为两组。我们感兴趣的结局是 90 天时的功能残疾程度，通过 ordinal Modified Rankin Scale（mRS）测量，死亡率，再灌注状态和出血性转化。
在 102 例 M1 闭塞患者中，71 例存在高密度大脑中动脉征。两组在年龄、基线 mRS、NIHSS、ASPECTS 和再灌注时间方面无显著差异。在调整其他重要预测因素（包括年龄、女性、高血压、就诊时血糖、ASPECTS、CTA 侧支评分和再通成功）后，高密度大脑中动脉征的缺失与依赖或死亡（更高的 mRS）的几率增加相关（OR：3.24，95%CI：1.30-8.06，P=0.011）。
在接受血栓切除术的 M1 闭塞患者中，高密度大脑中动脉征的缺失与功能结局较差相关。
