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相对脑血容量(rCBV)<42%与前循环大血管闭塞患者住院时间延长独立相关。

The relative cerebral blood volume (rCBV) <42% is independently associated with prolonged hospitalization in anterior circulation large vessel occlusion.

作者信息

Lakhani Dhairya A, Balar Aneri B, Vagal Vaibhav, Ali Subtain, Salim Hamza, Mei Janet, Khan Musharaf, Koneru Manisha, Wen Sijin, Lu Hanzhang, Wang Richard, Hillis Argye E, Heit Jeremy J, Albers Greg W, Dmytriw Adam A, Faizy Tobias, Wintermark Max, Nael Kambiz, Rai Ansaar T, Yedavalli Vivek S

机构信息

Department of Radiology and Radiological Sciences, Johns Hopkins University, USA.

Department of Neuroradiology, West Virginia University, USA.

出版信息

Neuroradiol J. 2025 May 31:19714009251348621. doi: 10.1177/19714009251348621.

Abstract

BackgroundThe pretreatment rCBV <42% lesion volume on CT Perfusion (CTP) has recently been shown to predict 90-day functional outcomes in stroke patients. However, its association with length of stay (LOS) has not yet been explored. This study aims to assess the relationship between rCBV <42% and prolonged LOS, defined as 7 days or longer.MethodsIn this retrospective evaluation of our prospectively collected database, we analyzed patients with confirmed anterior circulation large vessel occlusion on CT angiography who also received CT perfusion between 9/1/2017 and 10/01/2023. We used Student's t-test, Mann-Whitney U test, and Chi-Square test to assess differences. Logistic regression and ROC analyses were employed to evaluate the relationship between rCBV <42% and length of stay (LOS). A -value of ≤0.05 was considered statistically significant.ResultsA total of 268 patients met our inclusion criteria. Of these, 85 (31.7%) received intravenous thrombolysis (IVT), and 221 (82.5%) underwent mechanical thrombectomy (MT). After adjusting for several variables, logistic regression analysis revealed that an rCBV <42% lesion volume was independently associated with prolonged length of stay (LOS) (aOR = 0.98, < .001). ROC analysis indicated an area under the curve (AUC) of 0.66 ( < .001) for predicting prolonged LOS.ConclusionrCBV <42% lesion volume is independently associated with prolonged LOS. This parameter may serve as a useful adjunct tool in prognostication of AIS-LVO patients.

摘要

背景

最近研究表明,CT灌注成像(CTP)显示的预处理相对脑血容量(rCBV)<42%病变体积可预测卒中患者90天的功能预后。然而,其与住院时间(LOS)的关系尚未得到探讨。本研究旨在评估rCBV<42%与延长住院时间(定义为7天或更长时间)之间的关系。

方法

在对我们前瞻性收集的数据库进行的这项回顾性评估中,我们分析了在CT血管造影上确诊为前循环大血管闭塞且在2017年9月1日至2023年10月1日期间接受CT灌注检查的患者。我们使用学生t检验、曼-惠特尼U检验和卡方检验来评估差异。采用逻辑回归和ROC分析来评估rCBV<42%与住院时间(LOS)之间的关系。P值≤0.05被认为具有统计学意义。

结果

共有268例患者符合我们的纳入标准。其中,85例(31.7%)接受了静脉溶栓治疗(IVT),221例(82.5%)接受了机械取栓治疗(MT)。在对多个变量进行调整后,逻辑回归分析显示,rCBV<42%病变体积与延长住院时间(LOS)独立相关(调整后比值比[aOR]=0.98,P<.001)。ROC分析表明,预测延长住院时间的曲线下面积(AUC)为0.66(P<.001)。

结论

rCBV<42%病变体积与延长住院时间独立相关。该参数可能作为急性缺血性卒中伴大血管闭塞(AIS-LVO)患者预后评估的有用辅助工具。

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