动脉自旋标记法评估侧支循环灌注对急性前循环缺血性卒中的预后价值。
Prognostic value of collateral perfusion estimation by arterial spin labeling for acute anterior circulation ischemic stroke.
作者信息
Lee Taek-Jun, Roh Hong Gee, Kim Hyun Jeong, Jeon Yoo Sung, Ki Hee Jong, Park Jeong Jin, Lee Hyung Jin, Lee Ji Sung, Choi Jin Woo, Ryu Seon Young, Jung Yu Jin, Lee Sang Bong
机构信息
Department of Neurology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 64 Daeheung-Ro, Jung-Gu, Daejeon, 34943, Republic of Korea.
Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
出版信息
Neuroradiology. 2023 Dec;65(12):1695-1705. doi: 10.1007/s00234-023-03233-7. Epub 2023 Oct 14.
PURPOSE
This study aimed to verify the value of arterial spin labeling (ASL) collateral perfusion estimation for predicting functional outcomes in acute anterior circulation ischemic stroke.
METHODS
This secondary analysis of an ongoing prospective observational study included data from participants with acute ischemic stroke due to steno-occlusion of the internal carotid artery and/or the middle cerebral artery within 8 h of symptom onset. We compared the collateral map, which is a 5-phase collateral imaging derived from dynamic contrast-enhanced magnetic resonance angiography, and ASL to validate the ASL collateral perfusion estimation. Multiple logistic regression analyses were conducted to identify independent predictors of favorable functional outcomes.
RESULTS
One hundred forty-eight participants (68 ± 13 years, 96 men) were evaluated. The ASL collateral perfusion grade was positively correlated with the collateral perfusion grade of the collateral map (P < .001). Younger age (OR = 0.53, 95% CI = 0.36-0.78, P = .002), lower baseline NIHSS score (OR = 0.85, 95% CI = 0.78-0.92, P < .001), intermediate ASL collateral perfusion grade (OR = 4.02, 95% CI = 1.43-11.26, P = .008), good ASL collateral perfusion grade (OR = 26.37, 95% CI = 1.06-655.01, P = .046), and successful reperfusion (OR = 5.84, 95% CI = 2.08-16.42, P < .001) were independently associated with favorable functional outcomes.
CONCLUSION
ASL collateral perfusion estimation provides prognostic information, which can be helpful in guiding management decisions.
目的
本研究旨在验证动脉自旋标记（ASL）侧支循环灌注评估对预测急性前循环缺血性卒中功能结局的价值。
方法
这项正在进行的前瞻性观察性研究的二次分析纳入了症状发作8小时内因颈内动脉和/或大脑中动脉狭窄闭塞导致急性缺血性卒中的参与者的数据。我们比较了从动态对比增强磁共振血管造影获得的5期侧支循环成像的侧支循环图和ASL，以验证ASL侧支循环灌注评估。进行了多项逻辑回归分析以确定功能结局良好的独立预测因素。
结果
对148名参与者（68±13岁，96名男性）进行了评估。ASL侧支循环灌注分级与侧支循环图的侧支循环灌注分级呈正相关（P<.001）。年龄较小（OR=0.53，95%CI=0.36-0.78，P=.002）、基线美国国立卫生研究院卒中量表（NIHSS）评分较低（OR=0.85，95%CI=0.78-0.92，P<.001）、中等ASL侧支循环灌注分级（OR=4.02，95%CI=1.43-11.26，P=.008）、良好ASL侧支循环灌注分级（OR=26.37，95%CI=1.06-655.01，P=.046）和成功再灌注（OR=5.84，95%CI=2.08-16.42，P<.001）与功能结局良好独立相关。
结论
ASL侧支循环灌注评估可提供预后信息，有助于指导管理决策。
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