Gilbert Alize, Detraz Lili, Alexandre Pierre-Louis, Serfaty Jean-Michel, Desal Hubert, Toquet Claire, Bourcier Romain
26922l'institut du thorax Université de Nantes, CHU Nantes, INSERM, CNRS, Nantes, France.
26922CHU Nantes, Department of Neuroradiology, Nantes, France.
Interv Neuroradiol. 2022 Oct;28(5):523-530. doi: 10.1177/15910199211042473. Epub 2021 Sep 24.
Magnetic resonance imaging quantitative T2* mapping has shown reliable identification of thrombus red blood cell content in vitro. The thrombus composition has been in vivo, associated with outcomes after endovascular therapy for acute ischemic stroke. We aim to analyze the red blood cell content of thrombi retrieved from patients with large vessel occlusions in relation to the thrombus-T2* relaxation time in magnetic resonance imaging.
Consecutive acute ischemic stroke patients treated by endovascular therapy were scanned with an magnetic resonance imaging quantitative T2* mapping sequence. Quantitative histologic evaluations of red blood cell content were performed. A linear regression assessed the association between vascular risk factors, comorbidities, antithrombotic drugs intake, baseline National Institutes of Health Stroke Scale (NIHSS), intravenous thrombolysis before endovascular therapy, time between onset and groin puncture, patient's outcome at 3 months, magnetic resonance imaging quantitative T2* mapping results, and the red blood cell content of thrombi. The correlation between the mean thrombus-T2* relaxation time and red blood cell content was assessed by calculating the Pearson correlation coefficient.
Among 31 thrombi, 16 were "Fibrin rich" and 15 "red blood cell dominant." The median red blood cell content was 39 (range, 0-90; interquartile range, 37). The median (interquartile range) thrombus-T2* relaxation time was shorter in "red blood cell dominant" thrombi (21, interquartile range 6) than in "Fibrin rich" thrombi (24, interquartile range 7), without significant difference ( = 0.15), as shown in the Box plot. An inverse correlation between thrombus-T2* relaxation time and red blood cell content was found, with a correlation coefficient of -0.41 (95% CI, -0.67 to -0.08, = 0.02).
Our study shows that a shorter thrombus-T2* relaxation time is related to a higher red blood cell content within in vivo thrombi.
磁共振成像定量T2* 图谱已显示在体外能可靠地识别血栓的红细胞含量。血栓成分在体内与急性缺血性卒中血管内治疗后的预后相关。我们旨在分析从大血管闭塞患者中取出的血栓的红细胞含量与磁共振成像中血栓-T2* 弛豫时间的关系。
对接受血管内治疗的连续性急性缺血性卒中患者进行磁共振成像定量T2* 图谱序列扫描。对红细胞含量进行定量组织学评估。线性回归分析评估血管危险因素、合并症、抗血栓药物摄入、基线美国国立卫生研究院卒中量表（NIHSS）、血管内治疗前静脉溶栓、发病至股动脉穿刺时间、患者3个月时的预后、磁共振成像定量T2* 图谱结果与血栓红细胞含量之间的关联。通过计算Pearson相关系数评估平均血栓-T2* 弛豫时间与红细胞含量之间的相关性。
在31个血栓中，16个为“富含纤维蛋白”型，15个为“红细胞为主”型。红细胞含量中位数为39（范围0 - 90；四分位间距37）。如箱线图所示，“红细胞为主”型血栓的中位数（四分位间距）血栓-T2* 弛豫时间（21，四分位间距6）比“富含纤维蛋白”型血栓（24，四分位间距7）短，但无显著差异（P = 0.15）。发现血栓-T2* 弛豫时间与红细胞含量呈负相关，相关系数为 - 0.41（95% CI，- 0.67至 - 0.08，P = 0.02）。
我们的研究表明，较短的血栓-T2* 弛豫时间与体内血栓中较高的红细胞含量相关。
