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急性缺血性脑卒中患者的CT灌注成像:病前他汀类药物治疗的作用

CT Perfusion Imaging in Patients with Acute Ischemic Stroke: The Role of Premorbid Statin Treatment.

作者信息

Picchi Eliseo, Di Giuliano Francesca, Pucci Noemi, Sallustio Fabrizio, Minosse Silvia, Mascolo Alfredo Paolo, Marrama Federico, Ferrazzoli Valentina, Da Ros Valerio, Diomedi Marina, Federici Massimo, Garaci Francesco

机构信息

Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy.

Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy.

出版信息

Tomography. 2025 May 6;11(5):54. doi: 10.3390/tomography11050054.

Abstract

BACKGROUND

Statins appear to be useful in patients with acute ischemic stroke. Our aim was to evaluate the association between premorbid statin treatment and CT perfusion characteristics of acute ischemic stroke.

METHODS

A retrospective analysis of patients with acute stroke secondary to occlusion of large vessels in the anterior circulation was performed to assess collateral flow, ischemic core volume, and ischemic penumbra using CT angiography and CT perfusion maps. Fisher's exact test was used to compare baseline characteristics of patients in the two groups. The Wilcoxon rank-sum test for independent groups was used to compare all variables obtained for the two different groups with and without statin use.

RESULTS

We identified 61 patients, including 29 treated with statins and 32 not treated with statins before stroke onset matched by age, gender, and vascular risk factors except for hypercholesterolemia. The statin group showed lower National Institutes of health Stroke Scale scores at onset (14 ± 6.1 vs. 16 ± 4.5; = 0.04) and lower volumes of brain tissue characterized by impaired cerebral blood flow (CBF), cerebral blood volume (CBV), and Tmax9.5-25s; otherwise, no statistically significant difference was found in the volume of the Tmax16-25s between the two groups.

CONCLUSIONS

Premorbid statin treatment is associated with a favorable imaging condition of acute ischemic stroke in terms of ischemic core and ischemic penumbra volume.

摘要

背景

他汀类药物似乎对急性缺血性脑卒中患者有用。我们的目的是评估病前他汀类药物治疗与急性缺血性脑卒中CT灌注特征之间的关联。

方法

对前循环大血管闭塞继发急性脑卒中患者进行回顾性分析,使用CT血管造影和CT灌注图评估侧支血流、缺血核心体积和缺血半暗带。采用Fisher精确检验比较两组患者的基线特征。使用独立组的Wilcoxon秩和检验比较他汀类药物使用组和未使用组两组不同患者获得的所有变量。

结果

我们纳入了61例患者,其中29例在卒中发作前接受他汀类药物治疗,32例未接受他汀类药物治疗,两组患者在年龄、性别和除高胆固醇血症外的血管危险因素方面相匹配。他汀类药物治疗组在发病时美国国立卫生研究院卒中量表评分较低(14±6.1对16±4.5;P=0.04),以脑血流量(CBF)、脑血容量(CBV)和Tmax9.5 - 25s受损为特征的脑组织体积也较小;否则,两组之间Tmax16 - 25s的体积无统计学显著差异。

结论

就缺血核心和缺血半暗带体积而言,病前他汀类药物治疗与急性缺血性脑卒中的良好影像学状况相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fc2/12115380/c2e819044c9a/tomography-11-00054-g001.jpg

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