Mormina Enricomaria, Tessitore Agostino, Cavallaro Marco, Caragliano Antonio Armando, Buonomo Orazio, Longo Mirta, Granata Francesca, Caponnetto Michele, Vinci Sergio Lucio
Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.
Heliyon. 2022 Aug 17;8(8):e10288. doi: 10.1016/j.heliyon.2022.e10288. eCollection 2022 Aug.
Endovascular treatment (EVT) is a time-dependent procedure that aims to remove the arterial blood flow obstruction in brain vessels in acute ischemic stroke. In our center, the MRI patient selection protocol in acute ischemic stroke is performed with DWI, FLAIR, MR angiography (MRA) and MR cisternography (MRC) sequences. MRA and MRC are promptly and automatically fused in order to have a clear detection of vessel anatomy, before and during EVT.Our study aim is to evaluate if the fusion process between MRA and MRC could be considered time-safe and could influence EVT duration or outcome.
45 patients were retrospectively selected for the study and divided into 2 groups according to the presence of MRC sequence fused with MRA (Group 1) or not (Group 2 - controls).
MRA and MRC fusion was able to depict vessel anatomy in all subjects of Group 1 (22 patients, 12 females; age 75.59 years ± 10.87). Group 1 presented EVT time reduction ( = 0.040) (51.59 min ± 30.94) when compared to Group 2 (23 patients, 13 females; age 75.04 years ± 12.12) (71.96 min ± 34.55) of 20.37 min average. No differences between groups were detected evaluating: NIHSS at admission ( = 0.49) and discharge ( = 0.67), pre-stroke mRS ( = 0.89), mRS at 90 days ( = 0.62), ASPECT ( = 0.98) and ASPECT-DWI scores ( = 0.93), time from symptom onset to groin puncture ( = 0.80), thromboaspiration vs combined technique ( = 0.67), EVT success ( = 0.63).
Fusion of MRA and MRC is a safe and promising technique in promptly revealing vascular anatomy beyond vessel obstruction, and can play a role in EVT duration reduction.
血管内治疗（EVT）是一种时间依赖性的治疗方法，旨在清除急性缺血性卒中脑血管中的动脉血流阻塞。在我们中心，急性缺血性卒中的MRI患者选择方案采用弥散加权成像（DWI）、液体衰减反转恢复序列（FLAIR）、磁共振血管造影（MRA）和磁共振脑池造影（MRC）序列进行。在EVT之前和期间，MRA和MRC会迅速自动融合，以便清晰检测血管解剖结构。我们的研究目的是评估MRA和MRC之间的融合过程是否可被认为在时间上是安全的，以及是否会影响EVT的持续时间或结果。
回顾性选取45例患者进行研究，并根据是否存在与MRA融合的MRC序列分为两组（第1组）或未融合（第2组 - 对照组）。
MRA和MRC融合能够在第1组的所有受试者（22例患者，12例女性；年龄75.59岁±10.87）中描绘血管解剖结构。与第2组（23例患者，13例女性；年龄75.04岁±12.12）（71.96分钟±34.55）相比，第1组的EVT时间缩短（P = 0.040）（51.59分钟±30.94），平均缩短20.37分钟。在评估以下指标时，两组之间未检测到差异：入院时美国国立卫生研究院卒中量表（NIHSS）评分（P = 0.49）和出院时评分（P = 0.67）、卒中前改良Rankin量表（mRS）评分（P = 0.89）、90天时的mRS评分（P = 0.62）、脑血流灌注加权成像（ASPECT）评分（P = 0.98）和ASPECT-DWI评分（P = 0.93）、症状发作至股动脉穿刺的时间（P = 0.80）、血栓抽吸与联合技术（P = 0.67）、EVT成功率（P = 0.63）。
MRA和MRC融合是一种安全且有前景的技术，能够迅速揭示血管阻塞以外的血管解剖结构，并可在缩短EVT持续时间方面发挥作用。
