Wu Zhimin, Feng Qinglin, Liu Mengqi, Li Jie, Sun Xiaochuan, Shi Quanhong, Zhan Yan, Dan Wei, Yang Bocheng, Zheng Dinghao, Xia Yulong, Xie Yanfeng, Jiang Li
Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Neurosurgery, Chongqing University Three Gorges Hospital, Chongqing, China.
CNS Neurosci Ther. 2021 Sep;27(9):1077-1084. doi: 10.1111/cns.13689. Epub 2021 Jun 19.
To establish an artery and venous sinus occlusion image score (AVOIS) which is compatible in both cerebral arteries and venous system diseases.
A total of 188 consecutive patients with the final diagnosis of anterior circulation infarct (ACI) and 56 consecutive patients with cerebral venous and sinus thrombosis (CVST) were retrospectively studied. The AVOIS was developed based on the severity of occlusive changes of main intracranial arteries and venous sinuses (present = 0, partial occlusion = 1, absent = 2), and divided into four groups (CVST group: 0, 1-5, 6-10, >10. ACI group: 0, 1-5, 6-10, >10) arbitrarily. A receiver operating characteristic (ROC) curve was applied to discover the sensitivity and specificity of AVOIS. The National Institutes of Health Stroke Scale (NIHSS), Clot Burden Score (CBS) were set as the reference. Logistic regression models were developed to adjust for baseline clinical variables and AVOIS. Length of hospital stay (LOS) was also evaluated using the Kaplan-Meier estimator.
For the CVST group, a positive correlation between AVOIS and NIHSS was discovered (Spearman's ρ = 0.54, p < 0.001). For the ACI group, ROC showed relatively high sensitivity (84.8%) and specificity (81.8%). Besides, the probability of time to discharge was significantly different among the AVOIS subgroups as well (p < 0.001).
The AVOIS can be used to evaluate the treatment of patients with acute stroke caused by cerebral venous sinus thrombosis and anterior circulation large vessel occlusion. It is a reliable and convenient method that may help prompt prognosis and guide the treatment of individual patients.
建立一种适用于脑动脉和静脉系统疾病的动静脉窦闭塞图像评分（AVOIS）。
回顾性研究了188例最终诊断为前循环梗死（ACI）的连续患者和56例脑静脉和静脉窦血栓形成（CVST）的连续患者。AVOIS基于颅内主要动脉和静脉窦闭塞变化的严重程度制定（存在=0，部分闭塞=1，不存在=2），并任意分为四组（CVST组：0、1 - 5、6 - 10、>10。ACI组：0、1 - 5、6 - 10、>10）。应用受试者操作特征（ROC）曲线来发现AVOIS的敏感性和特异性。将美国国立卫生研究院卒中量表（NIHSS）、血栓负荷评分（CBS）作为参考。建立逻辑回归模型以调整基线临床变量和AVOIS。还使用Kaplan-Meier估计器评估住院时间（LOS）。
对于CVST组，发现AVOIS与NIHSS之间存在正相关（Spearman相关系数ρ = 0.54，p < 0.001）。对于ACI组，ROC显示出相对较高的敏感性（84.8%）和特异性（81.8%）。此外，AVOIS亚组之间出院时间的概率也有显著差异（p < 0.001）。
AVOIS可用于评估脑静脉窦血栓形成和前循环大血管闭塞所致急性卒中患者的治疗情况。它是一种可靠且便捷的方法，可能有助于提示预后并指导个体患者的治疗。
