Xu Hai-Bin, Sun Yu-Fei, Luo Na, Wang Jia-Qi, Chang Guo-Can, Tao Lin, Yang Ben-Qiang, Chen Hui-Sheng
Department of Neurology, General Hospital of Northern Theater Command, ShenYang, China.
Department of Radiology, General Hospital of Northern Theater Command, ShenYang, China.
Front Neurol. 2021 Mar 12;12:645590. doi: 10.3389/fneur.2021.645590. eCollection 2021.
Previous studies have demonstrated that Net Water Uptake (NWU) is associated with the development of malignant edema (ME). The current study aimed to investigate whether NWU calculated in standardized and blindly outlined regions of the middle cerebral artery can predict the development of ME. We retrospectively included 119 patients suffering from large hemispheric infarction within onset of 24 h. The region of the middle cerebral artery territory was blindly outlined in a standard manner to calculate NWU. Patients were divided into two groups according to the occurrence of ME, which is defined as space-occupying infarct requiring decompressive craniotomy or death due to cerebral hernia in 7 days from onset. The clinical characteristics were analyzed, and the receiver operating characteristic curve (ROC curve) was used to assess the predictive ability of NWU and other factors for ME. Multivariable analysis showed that NWU was an independent predictor of ME (OR 1.168, 95% CI 1.041-1.310). According to the ROC curve, NWU≥8.127% identified ME with good predictive power (AUC 0.734, sensitivity 0.656, specificity 0.862). NWU calculated in standardized and blindly outlined regions of the middle cerebral artery territory is also a good predictor for the development of ME in patients with large hemispheric infarction.
既往研究表明，净吸水量（NWU）与恶性脑水肿（ME）的发生有关。本研究旨在探讨在标准化且采用盲法勾勒的大脑中动脉区域计算得出的NWU是否能够预测ME的发生。我们回顾性纳入了119例在发病24小时内发生大面积半球梗死的患者。采用标准方法以盲法勾勒大脑中动脉区域来计算NWU。根据ME的发生情况将患者分为两组，ME定义为发病7天内需行减压性颅骨切除术的占位性梗死或因脑疝死亡。分析临床特征，并采用受试者工作特征曲线（ROC曲线）评估NWU及其他因素对ME的预测能力。多变量分析显示，NWU是ME的独立预测因素（比值比1.168，95%置信区间1.041 - 1.310）。根据ROC曲线，NWU≥8.127%对ME具有良好的预测效能（曲线下面积0.734，敏感性0.656，特异性0.862）。在标准化且采用盲法勾勒的大脑中动脉区域计算得出的NWU也是大面积半球梗死患者ME发生的良好预测因素。
