Journal of Neuroimaging最新文献_第10页

Transorbital sonography in idiopathic intracranial hypertension: Single-center study, systematic review and meta-analysis 特发性颅内高压的经眶超声检查：单中心研究、系统综述和荟萃分析。

IF 2.4 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2023-10-11 DOI: 10.1111/jon.13160

Eleni Bakola, Lina Palaiodimou, Andreas Eleftheriou, Katerina Foska, Anastasia Pikouli, Maria Stefanatou, Maria Chondrogianni, Georgios Velonakis, Elissavet Andreadou, Marianna Papadopoulou, Theodoros Karapanayiotides, Christos Krogias, Chrysa Arvaniti, Georgios Tsivgoulis

Background and Purpose

Transorbital sonography (TOS) provides a noninvasive tool to detect intracranial pressure by assessing optic nerve sheath diameter (ONSD) and optic disc elevation (ODE). The utility of TOS in the diagnosis of idiopathic intracranial hypertension (IIH) has been increasingly recognized.

Methods

A single-center case-control study sought to compare TOS-acquired ONSD and ODE among IIH-cases versus patients with other neurological diseases (controls). Furthermore, a systematic review and meta-analysis was conducted to present pooled mean differences and diagnostic measures of ONSD and ODE between IIH-cases and controls.

Results

In the single-center study, consisting of 31 IIH-cases and 34 sex- and age-matched controls, ONSD values were higher among IIH-cases than controls (p<.001), while ODE was more prevalent in cases (65% vs. 15%; p<.001). The receiver-operating characteristic (ROC)-curve analysis revealed that the optimal cutoff value of ONSD for predicting IIH was 5.15 mm, with an area under the curve (AUC) of 0.914 (95% confidence interval [CI]: 0.861-0.967) and sensitivity and specificity values of 85% and 90%, respectively. In a meta-analysis of 14 included studies with 415 IIH-cases, ONSD and ODE values were higher in IIH-cases than controls (mean difference in ONSD 1.20 mm; 95% CI: 0.96-1.44 mm and in ODE 0.3 mm; 95% CI: 0.33-0.67 mm). With regard to ONSD, pooled sensitivity, specificity, and diagnostic odds ratio were calculated at 85.5% (95% CI: 77.9-90.8%), 90.7% (95% CI: 84.6-94.5%), and 57.394 (95% CI: 24.597-133.924), respectively. The AUC in summary ROC-curve analysis was 0.878 (95% CI: 0.858-0.899) with an optimal cutoff point of 5.0 mm.

Conclusions

TOS has a high diagnostic utility for the noninvasive diagnosis of IIH and may deserve wider implementation in everyday clinical practice.

背景和目的：经眶超声（TOS）通过评估视神经鞘直径（ONSD）和视盘抬高（ODE），为检测颅内压提供了一种无创工具。TOS在特发性颅内高压（IIH）诊断中的作用越来越得到认可。方法：一项单中心病例对照研究试图比较IIH患者与其他神经系统疾病患者（对照组）的TOS获得性ONSD和ODE。此外，进行了一项系统综述和荟萃分析，以呈现IIH病例和对照组之间ONSD和ODE的汇总平均差异和诊断指标。结果：在由31例IIH病例和34名性别和年龄匹配的对照组组成的单中心研究中，IIH病例的ONSD值高于对照组（P结论：TOS对IIH的非侵入性诊断具有很高的诊断实用性，可能值得在日常临床实践中更广泛地实施。

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引用次数: 0

A novel fully automated method for measuring ASPECTS to improve stroke diagnosis: Comparison to traditional ASPECTS 一种新的全自动测量ASPECTS以改进中风诊断的方法：与传统ASPECTS的比较。

IF 2.4 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2023-10-08 DOI: 10.1111/jon.13159

Georg Gohla, Ricarda Schwarz, Georg Bier, Arne Estler, Malte N. Bongers, Hendrik Ditt, Jan Fritz, André Kemmling, Ulrike Ernemann, Marius Horger

Background and Purpose

To compare the accuracy of subjective Alberta Stroke Program Early CT Score (sASPECTS) evaluation and that of an automated prototype software (aASPECTS) on nonenhanced CT (NECT) in patients with early anterior territory stroke and controls using side-to-side quantification of hypoattenuated brain areas.

Methods

We retrospectively analyzed the NECT scans of 42 consecutive patients with ischemic stroke before reperfusion and 42 controls using first sASPECTS and subsequently aASPECTS. We assessed the differences in Alberta Stroke Program Early CT Score (ASPECTS) and calculated the sensitivity and specificity of NECT with CT perfusion, whereas cerebral blood volume (CBV) served as the reference standard for brain infarction.

Results

The clot was located in the middle cerebral artery (MCA) in 47.6% of cases and the internal carotid artery (ICA) in 28.6% of cases. Ten cases presented combined ICA and MCA occlusions. The stroke was right sided in 52.4% of cases and left sided in 47.6%. Reader-based NECT analysis yielded a median sASPECTS of 10. The median CBV-based ASPECTS was 7. Compared to the area of decreased CBV, sASPECTS yielded a sensitivity of 12.5% and specificity of 86.8%. The software prototype (aASPECTS) yielded an overall sensitivity of 65.5% and a specificity of 92.2%. The interreader agreement for ASPECTS evaluation of admission NECT and follow-up CT was almost perfect (κ = .93). The interreader agreement of the CBV color map evaluation was substantial (κ = .77).

Conclusions

aASPECTS of NECT can outperform sASPECTS for stroke detection.

背景和目的：比较阿尔伯塔省脑卒中项目早期CT评分（sASPECTS）主观评估和自动化原型软件（aASPECTS）对早期前区脑卒中患者和对照组非强化CT评分（NECT）的准确性，使用低衰减脑区的侧边量化。方法：我们回顾性分析了42例缺血性脑卒中患者在再灌注前的NECT扫描，以及42例对照组首次使用sASPECTS和随后使用aSPECTS的NECT。我们评估了阿尔伯塔省卒中项目早期CT评分（ASPECTS）的差异，并计算了NECT与CT灌注的敏感性和特异性，而脑血容量（CBV）作为脑梗死的参考标准。结果：血栓位于大脑中动脉（MCA）的占47.6%，位于颈内动脉（ICA）的占28.6%。10例出现ICA和MCA合并闭塞。52.4%的病例为右侧，47.6%为左侧。基于读者的NECT分析得出的平均sASPECTS为10。基于CBV的ASPECTS中位数为7。与CBV降低的面积相比，sASPECTS的灵敏度为12.5%，特异性为86.8%。软件原型（aASPECTS）的总体灵敏度为65.5%，特异性达92.2%。入院NECT和随访CT的ASPECTS评估的读者间一致性几乎是完美的（κ=.93）。CBV彩色图评估的读者之间一致性是实质性的（κ=.77）。结论：NECT在中风检测方面可以优于sASPECTS。

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引用次数: 0

The current state of spinal cord functional magnetic resonance imaging and its application in clinical research 脊髓功能磁共振成像的研究现状及其在临床研究中的应用

IF 2.4 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2023-09-23 DOI: 10.1111/jon.13158

Grace Haynes, Fauziyya Muhammad, Ali F. Khan, Esmaeil Mohammadi, Zachary A. Smith, Lei Ding

Since its development, spinal cord functional magnetic resonance imaging (fMRI) has utilized various methodologies and stimulation protocols to develop a deeper understanding of a healthy human spinal cord that lays a foundation for its use in clinical research and practice. In this review, we conducted a comprehensive literature search on spinal cord fMRI studies and summarized the recent advancements and resulting scientific achievements of spinal cord fMRI in the following three aspects: the current state of spinal cord fMRI methodologies and stimulation protocols, knowledge about the healthy spinal cord's functions obtained via spinal cord fMRI, and fMRI's exemplary usage in spinal cord diseases and injuries. We conclude with a discussion that, while technical challenges exist, novel fMRI technologies for and new knowledge about the healthy human spinal cord have been established. Empowered by these developments, investigations of pathological and injury states within the spinal cord have become the next important direction of spinal cord fMRI. Recent clinical investigations into spinal cord pathologies, for example, fibromyalgia, multiple sclerosis, spinal cord injury, and cervical spondylotic myelopathy, have already provided deep insights into spinal cord impairments and the time course of impairment-caused changes. We expect that future spinal cord fMRI advancement and research development will further enhance our understanding of various spinal cord diseases and provide the foundation for evaluating existing and developing new treatment plans.

自其发展以来，脊髓功能磁共振成像(fMRI)已经利用各种方法和刺激方案来深入了解健康的人类脊髓，为其在临床研究和实践中的应用奠定了基础。在本文中，我们对脊髓功能磁共振研究进行了全面的文献检索，并从以下三个方面总结了脊髓功能磁共振的最新进展和取得的科学成果:脊髓功能磁共振方法和刺激方案的现状，通过脊髓功能磁共振获得的关于健康脊髓功能的知识，以及fMRI在脊髓疾病和损伤中的示范应用。最后，我们讨论到，尽管存在技术挑战，但关于健康人类脊髓的新型fMRI技术和新知识已经建立起来。在这些发展的推动下，脊髓病理和损伤状态的研究已成为脊髓功能磁共振成像的下一个重要方向。最近对脊髓病理的临床研究，如纤维肌痛、多发性硬化症、脊髓损伤和脊髓型颈椎病，已经为脊髓损伤和损伤引起的变化的时间过程提供了深入的了解。我们期待未来脊髓功能磁共振成像技术的进步和研究发展将进一步增进我们对各种脊髓疾病的认识，并为评估现有治疗方案和开发新的治疗方案提供基础。

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引用次数: 1

Annual Meeting of the American Society of Neuroimaging 美国神经影像学会年会。

IF 2.4 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2023-09-23 DOI: 10.1111/jon.13157

引用次数: 0

Computed tomography perfusion software pipelines to assess parameter maps and ischemic volumes: A comparative study 计算机断层扫描灌注软件管道评估参数图和缺血体积:一项比较研究

IF 2.4 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2023-09-22 DOI: 10.1111/jon.13154

Wei Lu, Feirong Yao, Congguo Yin, Shu Wan, Xin Liu, Chongxin He, Xiaochang Leng, Jens Fiehler, Adnan H. Siddiqui, Ya Peng, Jianping Xiang

This study was dedicated to investigating the agreement of the calculated results of two CT perfusion (CTP) postprocessing software packages, including parameter maps and ischemic volume, focusing on the infarct core volume (ICV) and penumbra volume (PV).

背景与目的本研究旨在探讨两种CT灌注(CTP)后处理软件包计算结果的一致性，包括参数图和缺血体积，重点是梗死核心体积(ICV)和半影体积(PV)。方法回顾性收集235例急性缺血性脑卒中患者行CTP检查。使用RAPID CTP和AccuCTP两种软件管道对所有图像进行分析，并根据两种软件包计算的ICV和PV结果进行对比分析。参数图的一致性通过均方根误差和Bland-Altman分析进行评价。采用类内相关系数(ICC)和Bland-Altman分析对ICV和PV一致性进行评价。分析了基于多阈值的ICV和PV的精度。结果AccuCTP与RAPID CTP的ICV和PV具有良好的一致性。参数图的相对差异均在10%以内，Bland-Altman分析也显示出很强的一致性。从普通最小二乘拟合结果来看，ICV和PV的拟合优度都非常高(ICV, R2= 0.975 [p<.001];PV, R2= 0.964 [p<.001])。对于ICC分析，两者的ICC得分都很高(ICV ICC 0.984, 95% CI[置信区间]0.973-0.989;Pv ICC 0.955, 95% ci 0.947-0.964)。此外，基于ICV和PV的多阈值分析也获得了可靠的分析精度。结论AccuCTP与RAPID CTP的图像分析结果吻合良好，可作为RAPID CTP软件在脑卒中临床中的替代分析工具。

引用次数: 0

Nodal properties of the resting-state brain functional network in childhood and adolescence 儿童和青少年静息状态脑功能网络的节点特性

IF 2.4 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2023-09-21 DOI: 10.1111/jon.13155

Yu Tian, Gaoqiang Xu, Jing Zhang, Kuntao Chen, Songjiang Liu

Background and Purpose

Changes in the topological properties of brain functional network nodes during childhood and adolescence can provide more detailed and intuitive information on the rules of brain development. This study aims to explore the characteristics of nodal attributes in child and adolescent brain functional networks and analyze the correlation between nodal attributes in different brain regions and age.

Methods

Forty-two healthy volunteers aged 6-18 years who were right-handed primary and middle school students were recruited, and the subgroup analysis included children (6-12 years, n = 19) and adolescents (13-18 years, n = 23). Resting-state functional magnetic resonance imaging data were collected using a 3.0 Tesla MRI scanner. The topological properties of the functional brain network were analyzed using graph theory.

Results

Compared with the children group, the degree centrality and nodal efficiency of multiple brain regions in the adolescent group were significantly increased, and the nodal shortest path was reduced (q<0.05, false discovery rate corrected). These brain regions were widely distributed in the whole brain and significantly correlated with age. Compared with the children group, reduced degree centralities were observed in the left dorsolateral fusiform gyrus, left rostral cuneus gyrus, and right medial superior occipital gyrus.

Conclusion

The transmission efficiency of the brain's core network gradually increased, and the subnetwork function gradually improved in children and adolescents with age. The functional development of each brain area in the occipital visual cortex was uneven and there was functional differentiation within the occipital visual cortex.

背景与目的研究儿童和青少年时期脑功能网络节点拓扑特性的变化，可以更详细、直观地了解大脑发育规律。本研究旨在探讨儿童和青少年脑功能网络的节点属性特征，并分析不同脑区节点属性与年龄的相关性。方法招募6 ~ 18岁健康右撇子中小学生志愿者42人，亚组分析包括儿童(6 ~ 12岁，n = 19)和青少年(13 ~ 18岁，n = 23)。静息状态功能磁共振成像数据采集采用3.0 Tesla MRI扫描仪。利用图论分析了脑功能网络的拓扑性质。结果与儿童组比较，青少年组多脑区度中心性和多脑区节点效率显著提高，节点最短路径显著减少(q<0.05，错误发现率得到纠正)。这些脑区广泛分布于全脑，且与年龄显著相关。与儿童组比较，左梭状回背外侧、左喙侧楔回、右内侧枕上回的中心性程度降低。结论儿童青少年随着年龄的增长，大脑核心网络的传输效率逐渐提高，子网络功能逐渐完善。枕视皮层各脑区功能发育不均匀，且枕视皮层内部存在功能分化。

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引用次数: 0

Brain hypometabolism in non-demented microtubule-associated protein tau H1 carriers with Parkinson's disease 帕金森病非痴呆性微管相关蛋白tau H1携带者的脑代谢降低

IF 2.4 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2023-09-19 DOI: 10.1111/jon.13156

Carmen Gasca-Salas, Clara Trompeta, Miguel López-Aguirre, Rafael Rodríguez Rojas, Jordi Clarimon, Oriol Dols-Icardo, Shaimaa El Bounasri, Pasqualina Guida, David Mata-Marín, Frida Hernández-Fernández, Connie Marras, Lina García-Cañamaque, Isabel Plaza de las Heras, Ignacio Obeso, Lydia Vela, Beatriz Fernández-Rodríguez

Background and Purpose

The microtubule-associated protein tau (MAPT) H1 homozygosity (H1/H1 haplotype) is a genetic risk factor for neurodegenerative diseases, such as Parkinson's disease (PD). MAPT H1 homozygosity has been associated with conversion to PD; however, results are conflicting since some studies did not find a strong influence. Cortical hypometabolism is associated with cognitive impairment in PD. In this study, we aimed to evaluate the metabolic pattern in nondemented PD patients MAPT H1/H1 carriers in comparison with MAPT H1/H2 haplotype. In addition, we evaluated domain-specific cognitive differences according to MAPT haplotype.

Methods

We compared a group of 26 H1/H1 and 20 H1/H2 carriers with late-onset PD. Participants underwent a comprehensive neuropsychological cognitive evaluation and a [18F]-Fluorodeoxyglucose PET-MR scan.

Results

MAPT H1/H1 carriers showed worse performance in the digit span forward test of attention compared to MAPT H1/H2 carriers. In the [18F]-Fluorodeoxyglucose PET comparisons, MAPT H1/H1 displayed hypometabolism in the frontal cortex, parahippocampal, and cingulate gyrus, as well as in the caudate and globus pallidus.

Conclusion

PD patients MAPT H1/H1 carriers without dementia exhibit relative hypometabolism in several cortical areas as well as in the basal ganglia, and worse performance in attention than MAPT H1/H2 carriers. Longitudinal studies should assess if lower scores in attention and dysfunction in these areas are predictors of dementia in MAPT H1/H1 homozygotes.

背景与目的微管相关蛋白tau (MAPT) H1纯合性(H1/H1单倍型)是神经退行性疾病(如帕金森病(PD))的遗传危险因素。MAPT H1纯合性与PD的转化有关;然而，由于一些研究没有发现强烈的影响，结果是相互矛盾的。皮层代谢低下与帕金森病患者的认知障碍有关。在这项研究中，我们旨在比较MAPT H1/H1单倍型和MAPT H1/H2单倍型在非痴呆PD患者中的代谢模式。此外，我们根据MAPT单倍型评估了特定领域的认知差异。方法将26例H1/H1和20例H1/H2携带者与晚发型PD患者进行比较。参与者接受了全面的神经心理学认知评估和[18F]-氟脱氧葡萄糖PET-MR扫描。结果MAPT H1/H1携带者在数字跨距前向注意测验中的表现较MAPT H1/H2携带者差。在[18F]-氟脱氧葡萄糖PET比较中，MAPT H1/H1在额叶皮质、海马旁和扣带回以及尾状和白球中表现出低代谢。结论MAPT H1/H1携带者与MAPT H1/H2携带者相比，未发生痴呆的PD患者在多个皮质区和基底节区均表现出相对低代谢，注意力表现更差。纵向研究应该评估在这些区域的注意力和功能障碍得分较低是否是MAPT H1/H1纯合子痴呆的预测因素。

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引用次数: 0

Risk of new cerebral ischemic events in patients with symptomatic internal carotid artery stenosis while awaiting carotid stent placement 有症状的颈内动脉狭窄患者在等待放置颈动脉支架期间发生新脑缺血事件的风险

IF 2.4 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2023-09-11 DOI: 10.1111/jon.13150

Navpreet Bains, Ravi S. Nunna, Xiaoyu Ma, Rami Fakih, Attiya Jaura, Brandi R. French, Farhan Siddiq, Camilo R. Gomez, Adnan I. Qureshi

Background and purpose

Although there is an emphasis on performing carotid artery stent (CAS) placement within 2 weeks after index event of transient ischemic attack (TIA) or minor stroke in patients with significant extracranial internal carotid artery (ICA) stenosis, the risks and characteristics of recurrent cerebral ischemic event while waiting for CAS placement are not well defined.

Method

We analyzed patients admitted to our institution over a 45-month period with symptomatic extracranial ICA stenosis. We identified any new cerebral ischemic events that occurred between index cerebral or retinal ischemic event and CAS placement and categorized them as TIA and minor or major ischemic strokes. We calculated the risk of new ipsilateral cerebral ischemic events between index cerebral or retinal ischemic event and CAS placement.

Results

The mean age of 131 patients analyzed was 67 years (range: 47-94 years; 92 were men), and 94 and 37 patients had 70%-99% and 50%-69% severity of stenosis, respectively. The mean and median time intervals between index cerebral or retinal ischemic event and CAS performance were 28 (standard deviation [SD] 30) and 7 (interquartile range 33) days, respectively. A total of 9 of 131 patients (6.9%, 95% confidence interval 2.5%-11.2%) experienced new cerebral ischemic events over 3637 patient days of observation. The risk of new ipsilateral cerebral ischemic events was 2.5 per 1000 patient days of observation.

Conclusion

We estimated the risk of new ipsilateral cerebral ischemic events in patients with ICA stenosis ≥50% in severity while waiting for CAS placement to guide appropriate timing of procedure.

背景与目的颅外颈内动脉(ICA)明显狭窄的患者，虽然强调在短暂性脑缺血发作(TIA)或轻微卒中后2周内进行颈动脉支架(CAS)置入，但等待置入CAS的时间内再次发生脑缺血事件的风险和特点尚未明确。方法对我院收治的45个月以上有颅外ICA狭窄症状的患者进行分析。我们确定了在脑指数或视网膜缺血性事件与CAS放置之间发生的任何新的脑缺血事件，并将其分类为TIA和轻微或严重缺血性卒中。我们计算了指数脑或视网膜缺血事件与CAS放置之间新的同侧脑缺血事件的风险。结果131例患者平均年龄67岁(47 ~ 94岁;男性92例)，狭窄严重程度分别为70% ~ 99%和50% ~ 69%的分别为94例和37例。脑或视网膜缺血事件指数与CAS表现之间的平均和中位数时间间隔分别为28天(标准差[SD] 30)和7天(四分位数间距33)。在3637患者日的观察中，131例患者中有9例(6.9%，95%可信区间2.5%-11.2%)出现了新的脑缺血事件。新发生同侧脑缺血事件的风险为每1000患者日2.5例。结论:我们估计了严重程度≥50%的ICA狭窄患者在等待放置CAS时发生新的同侧脑缺血事件的风险，以指导适当的手术时机。

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引用次数: 0

Evaluation of 3-dimensional stereotactic surface projection rendering of arterial spin labeling data in a clinical cohort 评价动脉自旋标记数据在临床队列中的三维立体定向表面投影绘制

IF 2.4 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2023-09-11 DOI: 10.1111/jon.13153

Jalal B. Andre, Murat Alp Oztek, Yoshimi Anzai, Gregory J. Wilson, Mahmud Mossa-Basha, Daniel S. Hippe, Michael N. Hoff, Donna J. Cross, Satoshi Minoshima

Background and Purpose

To assess the feasibility of 3-dimensional stereotactic surface projection (3D-SSP) as applied to arterial spin labeling (ASL) in a clinical pilot study.

Methods

A retrospective sample of 10 consecutive patients who underwent ASL as part of a clinically indicated MR examination was collected during this pilot study. Five additional subjects with normal cerebral perfusion served as a control group. Following voxel-wise M0-correction, cerebral blood flow (CBF) quantification, and stereotactic anatomic standardization, voxel-wise CBF from an individual's ASL dataset was extracted to a set of predefined surface pixels (3D-SSP). A normal database was created from averaging the extracted CBF datasets of the control group. Patients’ datasets were compared individually with the normal database by calculating a Z-score on a pixel-by-pixel basis and were displayed in 3D-SSP views for visual inspection. Independent, two-expert reader assessment, using a 3-point scale, compared standard quantitative CBF images to the 3D-SSP maps.

Results

Patterns and severities of regionally reduced CBF were identified, by both independent readers, in the 3D-SSP maps. Reader assessment demonstrated preference for 3D-SSP over traditionally displayed standard quantitative CBF images in three of four evaluated imaging metrics (p = .026, .031, and .013, respectively); 3D-SSP maps were never found to be inferior to the standard quantitative CBF images.

Conclusions

Three-dimensional SSP maps are feasible in a clinical population and enable quantitative data extraction and localization of perfusion abnormalities by means of stereotactic coordinates in a condensed display. The proposed method is a promising approach for interpreting cerebrovascular pathophysiology.

背景与目的评价三维立体定向表面投影技术(3D-SSP)应用于动脉自旋标记(ASL)的可行性。方法在本初步研究中收集了10例连续接受ASL作为临床指示MR检查的患者的回顾性样本。另加5名脑灌注正常的受试者作为对照组。在体素方向的m0校正、脑血流量(CBF)量化和立体定向解剖标准化之后，将个体ASL数据集中的体素方向的CBF提取到一组预定义的表面像素(3D-SSP)。对对照组提取的CBF数据集取平均值，建立正常数据库。通过逐像素计算z分数，将患者数据集与正常数据库进行单独比较，并显示在3D-SSP视图中进行目视检查。独立的两位专家读者评估，使用3分制，将标准定量CBF图像与3D-SSP地图进行比较。结果两个独立的读者在3D-SSP图中识别了区域减少的CBF的模式和严重程度。在四项评估的成像指标中，读者评估显示3D-SSP优于传统显示的标准定量CBF图像(p分别= 0.026、0.031和0.013);从未发现3D-SSP图比标准定量CBF图像差。结论三维SSP图在临床人群中是可行的，可以通过浓缩显示器中的立体定向坐标进行定量数据提取和灌注异常定位。该方法是一种很有前途的解释脑血管病理生理的方法。

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引用次数: 0

Noncontrast versus perfusion CT to select endovascular therapy in an extended time window: Systematic review/meta-analysis 非对比与灌注CT在延长时间窗口内选择血管内治疗:系统回顾/荟萃分析

IF 2.4 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2023-09-07 DOI: 10.1111/jon.13152

Xue Bai, Yao Zhang, Yi Sui

Background and Purpose

The effect of noncontrast CT (NCCT) on the eligibility for endovascular therapy (EVT) in an extended time window remains to be elucidated. We sought to assess the efficacy and safety of NCCT in comparison with CT perfusion (CTP) in selecting patients with acute ischemic stroke (AIS) for EVT 6-24 hours after onset.

Methods

PubMed, Embase, and Cochrane libraries were searched from inception to August 31, 2022, to identify all studies reporting 90-day outcomes of EVT in patients with AIS in an extended time window. A meta-analysis was performed for the pooled risk ratio (RR) with 95% confidence interval (CI) using a random-effects model. The primary outcome used to assess efficacy was good functional independence, defined as a modified Rankin Scale score of 0-2 at 90 days. Secondary outcomes included successful reperfusion, symptomatic intracranial hemorrhage (sICH), and mortality at 90 days.

Results

We included four nonrandomized studies with a total of 2685 patients. The outcomes of good functional independence at 90 days (RR = 0.98; 95% CI: 0.88-1.07; I² = 0%; p = .62), successful reperfusion (RR = 0.98; 95% CI: 0.93-1.03; I² = 50.5%; p = .11), sICH (RR = 1.11; 95% CI: 0.55-2.21; I² = 49.4%; p = .12), or mortality at 90 days (RR = 1.18; 95% CI: 0.99-1.40; I² = 0%; p = .42) did not differ significantly between the two groups.

Conclusions

These findings suggest that NCCT is as effective as CTP in selecting patients for EVT in an extended time window.

背景与目的非对比CT (NCCT)对延长时间窗内血管内治疗(EVT)适格性的影响仍有待阐明。我们试图评估NCCT与CT灌注(CTP)在选择急性缺血性卒中(AIS)患者发病后6-24小时进行EVT的有效性和安全性。方法检索PubMed、Embase和Cochrane文库，从开始到2022年8月31日，以确定所有报告AIS患者在延长时间窗口内90天EVT结果的研究。采用随机效应模型对合并风险比(RR)进行荟萃分析，95%置信区间(CI)。用于评估疗效的主要终点是良好的功能独立性，定义为90天时0-2的修正Rankin量表评分。次要结局包括再灌注成功、症状性颅内出血(siich)和90天死亡率。结果我们纳入了4项非随机研究，共2685例患者。90天功能独立良好的结局(RR = 0.98;95% ci: 0.88-1.07;i2 = 0%;p = 0.62)，再灌注成功(RR = 0.98;95% ci: 0.93-1.03;i2 = 50.5%;p = 0.11)， siich (RR = 1.11;95% ci: 0.55-2.21;i2 = 49.4%;p = 0.12)，或90天死亡率(RR = 1.18;95% ci: 0.99-1.40;i2 = 0%;P = 0.42)，两组间差异无统计学意义。结论NCCT与CTP在选择EVT患者时同样有效。

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