Department of Neurosurgery, Yagi Neurosurgical Hospital, Higashinariku, Osaka, Japan.
Department of Neurosurgery, Nara Medical University, Kashihara, Nara, Japan.
Brain Behav. 2023 Aug;13(8):e3163. doi: 10.1002/brb3.3163. Epub 2023 Jul 20.
Endovascular therapy (EVT) is performed for acute ischemic stroke (AIS) with large vessel occlusion (LVO), however, the treatment strategies and clinical outcomes differ between cardiac embolism (CE) and intracranial arteriosclerosis-derived LVO (ICAS-LVO). We analyzed whether the time-to-max (Tmax) volume derived from perfusion imaging predicted clinical classification in AIS patients before EVT.
Consecutive AIS patients with anterior circulation LVO evaluated by automated imaging software were retrospectively identified. Patients were classified into a CE group and an ICAS-LVO group, and parameters were compared between groups.
Thirty-nine patients were included and Tmax volume and Tmax > 6 s volume/Tmax > 4 s volume were significantly greater in the CE group than in the ICAS-LVO group (Tmax > 4 s volume: 261 mL vs. 149 mL, p = .01, Tmax > 6 s volume: 143 mL vs. 59 mL, p = .001, Tmax > 6 s volume/Tmax > 4 s volume: 0.59 vs. 0.40, p < .001). Multiple logistic regression analysis indicated an association between clinical classification and high Tmax > 6 s volume/Tmax > 4 s volume (p = .04).
The Tmax volume derived from perfusion imaging predicts the clinical classification of AIS patients before EVT.
血管内治疗（EVT）用于治疗伴有大血管闭塞（LVO）的急性缺血性脑卒中（AIS），然而，心源性栓塞（CE）和颅内动脉粥样硬化性 LVO（ICAS-LVO）的治疗策略和临床结局不同。我们分析了 EVT 前灌注成像得出的时间至峰值（Tmax）体积是否可以预测 AIS 患者的临床分类。
回顾性分析了经自动成像软件评估的前循环 LVO 的连续 AIS 患者。将患者分为 CE 组和 ICAS-LVO 组，并对两组间的参数进行比较。
共纳入 39 例患者，CE 组的 Tmax 体积和 Tmax＞6 s 体积/Tmax＞4 s 体积明显大于 ICAS-LVO 组（Tmax＞4 s 体积：261 mL 比 149 mL，p=0.01；Tmax＞6 s 体积：143 mL 比 59 mL，p=0.001；Tmax＞6 s 体积/Tmax＞4 s 体积：0.59 比 0.40，p＜0.001）。多变量逻辑回归分析表明，临床分类与高 Tmax＞6 s 体积/Tmax＞4 s 体积之间存在关联（p=0.04）。
灌注成像得出的 Tmax 体积可预测 EVT 前 AIS 患者的临床分类。
