Gharaibeh Khaled, Aladamat Nameer, Samara Mohammad, Mierzwa Adam T, Ali Ahsan, Zaidi Syed, Jumaa Mouhammad
Department of Neurology, University of Toledo College of Medicine, and Life Sciences, Toledo, OH, USA.
Promedica Stroke Network, Toledo, OH, USA.
Interv Neuroradiol. 2024 Feb 28:15910199241235431. doi: 10.1177/15910199241235431.
To assess the prognostic values of hyperdense sign on pretreatment non-contrast head CT scan for successful recanalization (mTICI ≥2b) and 90-day good functional outcome (mRs 0-2) in patients with acute ischemic stroke undergoing mechanical thrombectomy (MT).
Literature search on PubMed, EMBASE, and Cochrane databases from inception up to 1 November 2023 was conducted. Twelve studies which reported hyperdense sign, recanalization and clinical outcomes were included in qualitative synthesis and meta-analysis.
Pooled analysis demonstrated a statistically significant association between successful recanalization and hyperdense sign-positive patients who underwent MT (odd ratios (OR) = 1.47, 95% confidence interval (CI) = 1.03-2.10, = 0.04). No statistically significant association was demonstrated between presence of hyperdense sign and good functional outcome (OR = 1.04, 95% CI: 0.72-1.49, = 0.85) or symptomatic intracranial hemorrhage sICH (OR: 1.80, 95% CI 0.72-4.47, = 0.21).
This meta-analysis demonstrated that pre-intervention hyperdense sign on CT imaging might be useful in prediction of successful recanalization after MT.
评估急性缺血性脑卒中患者在接受机械取栓术（MT）前，非增强头部CT扫描上的高密度征对成功再通（改良脑梗死溶栓分级[mTICI]≥2b）和90天良好功能预后（改良Rankin量表[mRs] 0-2）的预测价值。
对PubMed、EMBASE和Cochrane数据库进行文献检索，检索时间范围从数据库建立至2023年11月1日。纳入12项报告了高密度征、再通情况和临床结局的研究进行定性综合分析和荟萃分析。
汇总分析显示，接受MT的高密度征阳性患者成功再通之间存在统计学显著关联（优势比[OR]=1.47，95%置信区间[CI]=1.03-2.10，P=0.04）。高密度征的存在与良好功能预后（OR=1.04，95%CI：0.72-1.49，P=0.85）或症状性颅内出血（sICH）（OR：1.80，95%CI 0.72-4.47，P=0.21）之间未显示出统计学显著关联。
这项荟萃分析表明，CT成像上的干预前高密度征可能有助于预测MT术后的成功再通。
