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基于磁敏感加权成像的不对称突出静脉对机械取栓术后实质内血肿的预测:一项回顾性队列研究

Prediction of parenchymal hematoma after mechanical thrombectomy by asymmetrical prominent veins: a retrospective cohort study based on susceptibility-weighted imaging.

作者信息

Li Ziqiang, Jiang Han, Yan Ruifang, Li Hao, Li Zhong, Bai Yan, Roberts Neil, Zhang Xianchang, Wang Meiyun

机构信息

Department of Magnetic Resonance, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China.

Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China.

出版信息

Quant Imaging Med Surg. 2025 Aug 1;15(8):7224-7234. doi: 10.21037/qims-2025-262. Epub 2025 Jul 24.

Abstract

BACKGROUND

Asymmetrical prominent veins (APVs) can help predict perfusion deficits and collateral circulation in large vessel occlusion acute ischemic stroke. Therefore, this study aimed to investigate the predictive value of APVs for parenchymal hematoma (PH) following mechanical thrombectomy (MT).

METHODS

This study retrospectively included consecutive patients with ischemic stroke due to middle cerebral artery occlusion who underwent MT. APVs were quantified using the APVs-Alberta Stroke Program Early Computed Tomography Score (ASPECTS) system, and we recorded the length and diameter of the susceptibility vessel sign (SVS), the number of cerebral microbleeds (CMBs), post-MT blood flow grading, and whether PH occurred within 24 hours. Logistic regression was performed to identify risk factors for PH.

RESULTS

A total of 89 patients with acute middle cerebral artery occlusion were included. APVs-ASPECTS was identified as an independent predictor of PH [odds ratio (OR) =0.604 (0.392, 0.930); P=0.022], and the length of SVS [OR =0.882 (0.792, 0.981); P=0.021] was an independent predictor of successful recanalization [modified Thrombolysis In Cerebral Ischemia (mTICI) 2b/3] after MT. There was no significant difference in the number of CMBs between the PH (+) and PH (-) groups (P=0.341).

CONCLUSIONS

In patients with acute middle cerebral artery occlusion who underwent MT, APVs-ASPECTS may be associated with the risk of PH.

摘要

背景

不对称突出静脉(APV)有助于预测大血管闭塞急性缺血性卒中的灌注缺损和侧支循环。因此,本研究旨在探讨APV对机械取栓(MT)后实质内血肿(PH)的预测价值。

方法

本研究回顾性纳入了因大脑中动脉闭塞而接受MT的连续缺血性卒中患者。使用APV-阿尔伯塔卒中项目早期计算机断层扫描评分(ASPECTS)系统对APV进行量化,我们记录了磁敏感血管征(SVS)的长度和直径、脑微出血(CMB)的数量、MT后的血流分级,以及PH是否在24小时内发生。进行逻辑回归以确定PH的危险因素。

结果

共纳入89例急性大脑中动脉闭塞患者。APV-ASPECTS被确定为PH的独立预测因子[比值比(OR)=0.604(0.392,0.930);P=0.022],SVS的长度[OR =0.882(0.792,0.981);P=0.021]是MT后成功再通[改良脑缺血溶栓(mTICI)2b/3]的独立预测因子。PH(+)组和PH(-)组之间的CMB数量无显著差异(P=0.341)。

结论

在接受MT的急性大脑中动脉闭塞患者中,APV-ASPECTS可能与PH风险相关。

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