Department of Radiology, Minhang Hospital, Fudan University, 170 Xin-Song Road, Shanghai, China.
Department of Ultrasound, Minhang Hospital, Fudan University, 170 Xin-Song Road, Shanghai, China.
Neurol India. 2023 Nov-Dec;71(6):1205-1210. doi: 10.4103/0028-3886.391400.
The aim of this study was to investigate the potential value of intracranial carotid artery calcification (ICAC) in therapeutic efficacy and functional outcomes in patients with anterior circulation acute ischemic stroke (AIS) undergoing intravenous thrombolysis.
A total of 207 patients with anterior circulation AIS who underwent intravenous thrombolysis were enrolled in this retrospective study. We divided them into three groups according to thin-slice head noncontrast computed tomography as follows: no ICAC, medial ICAC, and intimal ICAC. The differences in risk factors of different ICAC subtypes were compared, and the effect of ICAC subtype on hemorrhage transformation (HT) after intravenous thrombolysis was also evaluated. Functional outcomes were assessed at 90 days using the modified Rankin Scale.
Compared to the no and intimal ICAC, patients with the medial ICAC were older and more likely to have diabetes mellitus, hyperlipidemia, previous stroke, and atrial fibrillation. Moreover, the medial ICAC group had a high baseline National Institute of Health Stroke Scale (NIHSS) score and a high incidence of HT. Multivariate logistic regression analysis showed that baseline NIHSS score (odds ratio [OR]: 1.121, 95% confidence interval [CI]: 1.027-1.224) was independently associated with HT. Medial ICAC (OR: 7.418, 95% CI: 1.190-46.231) and baseline NIHSS score (OR: 1.141, 95% CI: 1.042-1.250) were independent risk factors of poor functional outcome at 90 days.
Medial ICAC could be a new imaging biomarker for predicting functional outcomes in patients with anterior circulation AIS undergoing intravenous thrombolysis. Medial ICAC and baseline NIHSS score were independently associated with poor prognosis at 90 days.
本研究旨在探讨颅内颈动脉硬化（ICAC）在接受静脉溶栓治疗的前循环急性缺血性脑卒中（AIS）患者的治疗效果和功能结局中的潜在价值。
本回顾性研究共纳入 207 例接受静脉溶栓治疗的前循环 AIS 患者。我们根据薄层头部非对比 CT 将他们分为三组：无 ICAC、中膜 ICAC 和内膜 ICAC。比较了不同 ICAC 亚型的危险因素差异，并评估了 ICAC 亚型对静脉溶栓后出血转化（HT）的影响。采用改良 Rankin 量表在 90 天评估功能结局。
与无 ICAC 和内膜 ICAC 相比，中膜 ICAC 患者年龄更大，更可能患有糖尿病、高脂血症、既往卒中及心房颤动。此外，中膜 ICAC 组基线国立卫生研究院卒中量表（NIHSS）评分较高，HT 发生率较高。多变量逻辑回归分析显示，基线 NIHSS 评分（比值比 [OR]：1.121，95%置信区间 [CI]：1.027-1.224）与 HT 独立相关。中膜 ICAC（OR：7.418，95% CI：1.190-46.231）和基线 NIHSS 评分（OR：1.141，95% CI：1.042-1.250）是 90 天功能结局不良的独立危险因素。
中膜 ICAC 可能是预测接受静脉溶栓治疗的前循环 AIS 患者功能结局的新影像学标志物。中膜 ICAC 和基线 NIHSS 评分与 90 天预后不良独立相关。
