使用阿尔伯塔卒中计划静脉相 CT 早期 CT 评分预测血管内血栓切除术后急性缺血性卒中患者的最终梗死面积和临床预后。

IF 1.1 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Acta radiologica Pub Date : 2024-11-18 DOI:10.1177/02841851241291928

Zi-Xin Yin, Guang-Chen Shen, Wen-Jing Ni, Shan-Shan Lu, Sheng Liu, Hai-Bin Shi, Xiao-Quan Xu, Fei-Yun Wu

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引用次数: 0

摘要

背景介绍阿尔伯塔省卒中项目早期计算机断层扫描评分（ASPECTS）是一种半定量工具，用于评估早期缺血性病变的程度和分布。目的：评估非对比CT（NCCT）、动脉期CT（APCT）或静脉期CT（VPCT）上的ASPECTS在预测后续弥散加权成像（DWI）的最终梗死核心（IC）以及血管内血栓切除术（EVT）后急性缺血性卒中（AIS）患者临床预后方面的价值：材料和方法：本中心共回顾性纳入了120例接受EVT治疗的AIS患者。采用斯皮尔曼秩相关系数分析 CT-ASPECTS 与随访 DWI-ASPECTS 之间的相关性。使用Bland-Altman图评估CT-ASPECTS和随访DWI-ASPECTS之间的平均差和一致性极限（LoA）。使用多变量逻辑回归和接收者操作特征曲线分析来确定独立因素，并评估它们在预测临床结果方面的性能：VPCT-ASPECTS与随访DWI-ASPECTS的相关性最高（r=0.846，P P pre）（几率比[OR]=1.162，95%置信区间[CI]=1.063-1.270；P=0.001），VPCT-ASPECTS（OR=0.728，95% CI=0.535-0.991；P=0.044）是与临床结果相关的独立因素。综合 NIHSSpre 和 VPCT-ASPECTS 的组合模型在预测良好临床预后方面表现出色（曲线下面积 [AUC]=0.807; 灵敏度=75.0%; 特异性=72.3%）：结论：VPCT-ASPECTS可能是预测EVT后AIS患者最终IC和临床预后的一种有前途的成像生物标志物。

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Predicting final infarct size and clinical outcomes in patients with acute ischemic stroke after endovascular thrombectomy using the Alberta Stroke Program early CT score on venous-phase CT.

Background: The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is a semi-quantitative tool for evaluating the extent and distribution of early ischemic changes.

Purpose: To assess the value of ASPECTS on non-contrast CT (NCCT), arterial-phase CT (APCT), or venous-phase CT (VPCT) in predicting the final infarct core (IC) on follow-up diffusion-weighted imaging (DWI) and the clinical outcomes of patients with acute ischemic stroke (AIS) after endovascular thrombectomy (EVT).

Material and methods: In total, 120 patients with AIS who underwent EVT in our center were retrospectively enrolled. Correlations between CT-ASPECTS and follow-up DWI-ASPECTS were analyzed using Spearman's rank correlation coefficient. Mean differences and limit of agreement (LoA) between CT-ASPECTS and follow-up DWI-ASPECTS were assessed using the Bland-Altman plots. Multivariate logistic regression and receiver operating characteristic curve analyses were used to identify independent factors and evaluate their performances in predicting the clinical outcomes.

Results: VPCT-ASPECTS exhibited the highest correlation with follow-up DWI-ASPECTS (r = 0.846, P < 0.001), followed by APCT-ASPECTS (r = 0.613, P < 0.001) and NCCT-ASPECTS (r = 0.557, P < 0.001). The mean difference between VPCT-ASPECTS and follow-up DWI-ASPECTS was 0.0 (limit of agreement = -2.1 to 2.1). National Institute of Health Stroke Scale (NIHSS) scores at admission (NIHSS_pre) (odds ratio [OR]=1.162, 95% confidence interval [CI]=1.063-1.270; P = 0.001) and VPCT-ASPECTS (OR=0.728, 95% CI=0.535-0.991; P = 0.044) were the independent factors associated with clinical outcomes. The combined model integrating NIHSS_pre and VPCT-ASPECTS exhibited an excellent performance in predicting good clinical outcomes (area under curve [AUC]=0.807; sensitivity=75.0%; specificity=72.3%).

Conclusion: VPCT-ASPECTS may be a promising imaging biomarker to predict the final IC and the clinical outcome of the patients with AIS after EVT.

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来源期刊

Acta radiologica 医学-核医学

CiteScore

2.70

自引率

0.00%

发文量

170

审稿时长

3-8 weeks

期刊介绍： Acta Radiologica publishes articles on all aspects of radiology, from clinical radiology to experimental work. It is known for articles based on experimental work and contrast media research, giving priority to scientific original papers. The distinguished international editorial board also invite review articles, short communications and technical and instrumental notes.