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MRI T2 FLAIR 血管高信号联合 DWI ASPECTS 对血管内治疗急性脑梗死预后的预测价值。

Value of MRI T2 FLAIR Vascular Hyperintensities Combined with DWI ASPECTS in Predicting the Prognosis of Acute Cerebral Infarction with Endovascular Treatment.

机构信息

Department of Neurology, Second People's Hospital of Lianyungang, Lianyungang, Jiangsu, China.

Department of Neurology, Lianyungang Cancer Hospital, Lianyungang, Jiangsu, China.

出版信息

Curr Med Imaging. 2023;19(11):1273-1278. doi: 10.2174/1573405619666230201103813.

DOI:10.2174/1573405619666230201103813
PMID:36725829
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10339677/
Abstract

OBJECTIVE

To explore the MRI T2 fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVH) combined with diffusion-weighted imaging (DWI) Alberta Stroke Program Early CT Score (ASPECTS) in predicting the prognosis of acute cerebral infarction (ACI) with endovascular treatment.

METHODS

The patients with ACI in the anterior circulation who underwent endovascular treatment from June 2016 to December 2020 were divided into a good prognosis group and a poor prognosis group according to the modified Rankin Scale (mRS) score at 90 days after the operation. The differences in general clinical baseline data, CT-ASPECTS, FVH, and DWI-ASPECTS between the two groups were analyzed. The receiver operating characteristic (ROC) curve was used to analyze the predictive power of prediction models on prognosis.

RESULTS

The results of the Binomial Logistic regression equation showed initial National Institute of Health stroke scale (NIHSS), Mori grade, DWI-ASPECTS, and FVH were independent risk factors for prognosis. The predictive power of the FVH + DWI-ASPECTS prediction model was highest, and the predictive power of DWI-ASPECTS was higher than that of CT-ASPECTS.

CONCLUSION

DWI-ASPECTS is better than CT-ASPECTS in predicting the prognosis of ACI with endovascular treatment, and the combined prediction model of FVH and DWI-ASPECTS has higher prediction performance, which can be used as a preoperative evaluation method to predict the effect of endovascular treatment for ACI.

摘要

目的

探讨磁共振成像 T2 液体衰减反转恢复(FLAIR)血管高信号(FVH)联合扩散加权成像(DWI)阿尔伯塔卒中项目早期 CT 评分(ASPECTS)对急性脑梗死(ACI)血管内治疗预后的预测价值。

方法

收集 2016 年 6 月至 2020 年 12 月接受血管内治疗的前循环 ACI 患者,根据术后 90 天改良 Rankin 量表(mRS)评分分为预后良好组和预后不良组,比较两组一般临床基线资料、CT-ASPECTS、FVH、DWI-ASPECTS 的差异,采用受试者工作特征(ROC)曲线分析各预测模型对预后的预测效能。

结果

二项 Logistic 回归方程结果显示,基线美国国立卫生研究院卒中量表(NIHSS)评分、Mori 分级、DWI-ASPECTS、FVH 是预后的独立危险因素,FVH+DWI-ASPECTS 预测模型预测效能最高,DWI-ASPECTS 预测效能高于 CT-ASPECTS。

结论

DWI-ASPECTS 较 CT-ASPECTS 更能预测 ACI 血管内治疗的预后,FVH 与 DWI-ASPECTS 联合预测模型具有更高的预测效能,可作为术前评估方法预测 ACI 血管内治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/10339677/1276e66748cb/CMIM-19-1273_F2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/10339677/743a127cbe7a/CMIM-19-1273_F1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/10339677/1276e66748cb/CMIM-19-1273_F2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/10339677/743a127cbe7a/CMIM-19-1273_F1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d633/10339677/1276e66748cb/CMIM-19-1273_F2.jpg

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本文引用的文献

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Outcomes of endovascular treatment in acute ischemic stroke patients with current malignancy.急性缺血性脑卒中伴现患恶性肿瘤患者的血管内治疗结局。
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Frequency, Risk Factors, and Prognosis of Dehydration in Acute Stroke.
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Predictive value of CT angiography source image ASPECTS in patients with anterior circulation acute ischemic stroke after endovascular treatment: ultimate infarct size and clinical outcome.CT 血管造影源图像 ASPECTS 在血管内治疗后前循环急性缺血性脑卒中患者中的预测价值:最终梗死体积和临床转归。
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