Department of Interventional Radiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China.
Department of Interventional Radiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
J Neurointerv Surg. 2023 Jul;15(7):639-643. doi: 10.1136/neurintsurg-2021-018557. Epub 2022 May 17.
Computed tomography perfusion (CTP) parameters have been shown to have predictive value for functional outcomes of patients with basilar artery occlusion (BAO). We report the predictive value of CTP-based software (CTP-Rapid Processing of Perfusion and Diffusion (RAPID); iSchemia View) for functional outcomes of patients with BAO after endovascular therapy (EVT).
Patients with BAO who underwent EVT were retrospectively analyzed in our center from December 2019 to July 2021. Baseline characteristics and imaging parameters from non-contrast CT, CT angiography (CTA), and CTP-RAPID were collected for analysis.
Among the 55 patients enrolled in this study, 22 (40.0%) achieved a good functional outcome (modified Rankin Scale score ≤3 at 90 days). In the univariate analysis, posterior circulation Alberta Stroke Program Early CT Score, Basilar Artery on CT Angiography score, posterior circulation CTA score, posterior communicating artery deficiency, perfusion deficit volume in time to maximum (Tmax) >4 s, Tmax >6 s, and mismatch volume were associated with functional outcomes (all p<0.05). In the multivariate analysis, perfusion deficit volume in Tmax >6 s (OR 1.011 (95% CI 1.001 to 1.020)) and posterior circulation CTA score (OR 0.435 (95% CI 0.225 to 0.840)) remained independent outcome predictors (all p<0.05).
Perfusion deficit volume in Tmax >6 s on CTP-RAPID imaging maps and basilar artery on CTA score have potential as functional outcome predictors in patients with BAO after EVT.
计算机断层灌注（CTP）参数已被证明对基底动脉闭塞（BAO）患者的功能结局具有预测价值。我们报告了基于 CTP 的软件（CTP-Rapid Processing of Perfusion and Diffusion（RAPID）；Ischemia View）对接受血管内治疗（EVT）后的 BAO 患者功能结局的预测价值。
我们回顾性分析了 2019 年 12 月至 2021 年 7 月期间在我院接受 EVT 的 BAO 患者。收集非对比 CT、CT 血管造影（CTA）和 CTP-RAPID 的基线特征和成像参数进行分析。
本研究共纳入 55 例患者，其中 22 例（40.0%）获得良好的功能结局（90 天时改良 Rankin 量表评分≤3）。单因素分析显示，后循环 Alberta 卒中项目早期 CT 评分、基底动脉 CTA 评分、后循环 CTA 评分、后交通动脉缺失、达峰时间（Tmax）>4s 的灌注缺损体积、Tmax>6s 和不匹配体积与功能结局相关（均 p<0.05）。多因素分析显示，Tmax>6s 时的灌注缺损体积（OR 1.011（95%CI 1.001 至 1.020））和后循环 CTA 评分（OR 0.435（95%CI 0.225 至 0.840））仍然是独立的结局预测因素（均 p<0.05）。
CTP-RAPID 成像图上 Tmax>6s 时的灌注缺损体积和 CTA 上的基底动脉评分可能是 EVT 后 BAO 患者功能结局的预测指标。
