Lakhani Dhairya A, Balar Aneri B, Ali Subtain, Khan Musharaf, Salim Hamza A, Koneru Manisha, Wen Sijin, Wang Richard, Mei Janet, Hillis Argye E, Heit Jeremy J, Albers Gregory W, Dmytriw Adam A, Faizy Tobias D, Wintermark Max, Nael Kambiz, Rai Ansaar T, Yedavalli Vivek S
The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA.
Department of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA.
Interv Neuroradiol. 2025 Jan 6:15910199241308322. doi: 10.1177/15910199241308322.
Pretreatment CT perfusion (CTP) marker relative cerebral blood volume (rCBV) < 42% lesion volume has recently shown to predict poor collateral status and poor 90-day functional outcome. However, there is a paucity of studies assessing its association with hemorrhagic transformation (HT). Here, we aim to assess the relationship between rCBV < 42% lesion volume with HT.
In this retrospective study, we included patients with acute ischemic stroke secondary to large vessel occlusion (AIS-LVO) of anterior circulation who had successful recanalization from two comprehensive stroke centers between 9/1/2017 and 10/01/2023. Successful recanalization was defined as modified treatment in cerebral infarction (mTICI) 2b or greater. Logistic regression analysis and ROC analysis were used to assess the relationship between rCBV <42% and HT.
In total, 150 patients (median age: 69 years, 58.7% female) met our inclusion criteria. On multivariable logistic regression analysis, taking into account age, sex, hypertension, hyperlipidemia, diabetes, prior stroke or transient ischemic attack, admission National Institute of Health stroke scale (NIHSS), Alberta Stroke Program Early CT Score (ASPECTS), and intravenous thrombolysis, rCBV <34% (aOR:1.01, < .05), rCBV <38% (aOR:1.01, < .05) and rCBV <42% (aOR:1.01, < .05) lesion volumes were independently associated with HT. On ROC analysis rCBV < 42% (AUC = 0.61, < .05) performed slightly better than rCBV < 38% (AUC = 0.59, < .05) and rCBV < 34% (AUC = 0.59, < .05) in predicting HT.
The rCBV <42% lesion volume is independently associated with HT in AIS-LVO patients who underwent successful recanalization.
近期研究表明，预处理CT灌注（CTP）标志物相对脑血容量（rCBV）<42%病变体积可预测侧支循环状态不佳及90天功能预后不良。然而，评估其与出血性转化（HT）相关性的研究较少。在此，我们旨在评估rCBV<42%病变体积与HT之间的关系。
在这项回顾性研究中，我们纳入了2017年9月1日至2023年10月1日期间在两个综合卒中中心成功再通的前循环大血管闭塞继发急性缺血性卒中（AIS-LVO）患者。成功再通定义为脑梗死改良治疗（mTICI）2b级或更高。采用逻辑回归分析和ROC分析评估rCBV<42%与HT之间的关系。
共有150例患者（中位年龄：69岁，58.7%为女性）符合纳入标准。在多变量逻辑回归分析中，考虑年龄、性别、高血压、高脂血症、糖尿病、既往卒中或短暂性脑缺血发作、入院时美国国立卫生研究院卒中量表（NIHSS）、阿尔伯塔卒中项目早期CT评分（ASPECTS）及静脉溶栓情况，rCBV<34%（调整后比值比：1.01，P<0.05）、rCBV<38%（调整后比值比：1.01，P<0.05）和rCBV<42%（调整后比值比：1.01，P<0.05）病变体积与HT独立相关。在ROC分析中，rCBV<42%（曲线下面积[AUC]=0.61，P<0.05）在预测HT方面略优于rCBV<38%（AUC=0.59，P<0.05）和rCBV<34%（AUC=0.59，P<0.05）。
在成功再通的AIS-LVO患者中，rCBV<42%病变体积与HT独立相关。
