Yang Liu, Cai Xinyi, Yan Yanhong, Hui Pinjing
Department of Stroke Center, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
J Neurosci Methods. 2025 Apr;416:110383. doi: 10.1016/j.jneumeth.2025.110383. Epub 2025 Jan 30.
One of the leading causes of disability and death is acute ischemic stroke (AIS) brought on by middle cerebral artery (MCA) obstruction. For the best patient care, it is essential to accurately anticipate the functional prognosis in the early stages of stroke. The ability of conventional clinical evaluations and imaging methods to deliver precise and timely prognostic information is frequently limited.
In this work, a predictive value for predicting functional outcome in patients with acute ischemic stroke caused by MCA blockage was developed utilizing transcranial Doppler (TCD) ultrasonography characteristics. Within 24 h after intravenous thrombolysis (IVT), TCD measures such as pulsatility index (PI), mean flow velocity (Vm), end-diastolic velocity (EDV), and peak systolic velocity (PSV) were assessed. Independent determinants of functional outcome, as determined by the modified Rankin Scale (mRS), were found using logistic regression analysis. These important factors were used to create a prediction model.
Favorable functional outcomes were substantially correlated with a number of TCD characteristics, such as the ratio of pulsatility index to mean flow velocity (rPI) and peak systolic velocity to end-diastolic velocity (rPSV). At three months after a stroke, a logistic regression model that included these measures together with additional clinical indicators showed excellent accuracy in predicting functional prognosis.
In individuals who have experienced an acute ischemic stroke as a result of MCA blockage, TCD ultrasonography parameters-in particular, rPSV and rPI-are useful prognostic indicators for forecasting functional prognosis. Early risk classification and individualized treatment plans can benefit from the creation of a quantitative model based on these criteria. Validating and improving this model in bigger and more varied patient groups should be the goal of future research.
大脑中动脉（MCA）阻塞引发的急性缺血性中风（AIS）是导致残疾和死亡的主要原因之一。为了实现最佳的患者护理，准确预测中风早期的功能预后至关重要。传统的临床评估和成像方法提供精确及时的预后信息的能力常常受到限制。
在这项研究中，利用经颅多普勒（TCD）超声特征开发了一种预测大脑中动脉阻塞所致急性缺血性中风患者功能结局的预测值。在静脉溶栓（IVT）后24小时内，评估诸如搏动指数（PI）、平均流速（Vm）、舒张末期流速（EDV）和收缩期峰值流速（PSV）等TCD测量值。使用逻辑回归分析确定由改良Rankin量表（mRS）决定的功能结局的独立决定因素。这些重要因素被用于创建一个预测模型。
良好的功能结局与一些TCD特征显著相关，如搏动指数与平均流速之比（rPI）以及收缩期峰值流速与舒张末期流速之比（rPSV）。在中风后三个月，一个包含这些测量值以及其他临床指标的逻辑回归模型在预测功能预后方面显示出极佳的准确性。
在因大脑中动脉阻塞而发生急性缺血性中风的个体中，TCD超声参数，特别是rPSV和rPI，是预测功能预后的有用预后指标。基于这些标准创建定量模型有助于早期风险分类和个性化治疗方案的制定。在更大且更多样化的患者群体中验证和改进该模型应是未来研究的目标。
