Subarachnoid iodine leakage on dual-energy computed tomography after mechanical thrombectomy is associated with malignant brain edema.

IF 4.5 1区 医学 Q1 NEUROIMAGING
Atsushi Ogata, Kuniaki Ogasawara, Masashi Nishihara, Ayako Takamori, Takashi Furukawa, Toshihiro Ide, Hiroshi Ito, Fumitaka Yoshioka, Yukiko Nakahara, Jun Masuoka, Haruki Koike, Hiroyuki Irie, Tatsuya Abe
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引用次数: 0

Abstract

Background: Dual-energy computed tomography (DE-CT) can differentiate between hemorrhage and iodine contrast medium leakage following mechanical thrombectomy (MT) for acute ischemic stroke (AIS). We determined whether subarachnoid hemorrhage (SAH) and subarachnoid iodine leakage (SAIL) on DE-CT following MT were associated with malignant brain edema (MBE).

Methods: We analyzed the medical records of 81 consecutive anterior circulation AIS patients who underwent MT. SAH or SAIL was diagnosed via DE-CT performed immediately after MT. We compared the procedural data, infarct volumes, MBE, and modified Rankin scale 0-2 at 90 days between patients with and without SAH and between patients with and without SAIL. Furthermore, we evaluated the association between patient characteristics and MBE.

Results: A total of 20 (25%) patients had SAH and 51 (63%) had SAIL. No difference in diffusion-weighted imaging (DWI)-infarct volume before MT was observed between patients with and without SAH or patients with and without SAIL. However, patients with SAIL had larger DWI-infarct volumes 1 day following MT than patients without SAIL (95 mL vs 29 mL; p=0.003). MBE occurred in 12 of 81 patients (15%); more patients with SAIL had MBE than patients without SAIL (22% vs 3%; p=0.027). Severe SAIL was significantly associated with MBE (OR, 12.5; 95% CI, 1.20-131; p=0.006), whereas SAH was not associated with MBE.

Conclusion: This study demonstrated that SAIL on DE-CT immediately after MT was associated with infarct volume expansion and MBE.

机械血栓切除术后双能计算机断层扫描显示的蛛网膜下腔碘渗漏与恶性脑水肿有关。
背景:双能计算机断层扫描(DE-CT)可区分急性缺血性脑卒中(AIS)机械性血栓切除术(MT)后的出血和碘造影剂渗漏。我们研究了机械取栓术后蛛网膜下腔出血(SAH)和蛛网膜下腔碘剂渗漏(SAIL)是否与恶性脑水肿(MBE)有关:我们分析了81例连续接受MT治疗的前循环AIS患者的病历。方法:我们分析了连续 81 例接受 MT 的前循环 AIS 患者的病历,并在 MT 后立即通过 DE-CT 诊断 SAH 或 SAIL。我们比较了有 SAH 和无 SAH 患者之间以及有 SAIL 和无 SAIL 患者之间的手术数据、梗死体积、MBE 和 90 天时的修正兰金量表 0-2 分值。此外,我们还评估了患者特征与 MBE 之间的关联:共有 20 名(25%)患者患有 SAH,51 名(63%)患者患有 SAIL。在 MT 之前,弥散加权成像(DWI)-梗死体积在 SAH 患者和非 SAH 患者之间、SAIL 患者和非 SAIL 患者之间均无差异。然而,与非 SAIL 患者相比,SAIL 患者在 MT 后 1 天的 DWI 梗死体积更大(95 毫升 vs 29 毫升;P=0.003)。81 例患者中有 12 例(15%)发生了 MBE;发生 MBE 的 SAIL 患者多于未发生 SAIL 的患者(22% vs 3%;P=0.027)。严重的 SAIL 与 MBE 明显相关(OR,12.5;95% CI,1.20-131;p=0.006),而 SAH 与 MBE 无关:本研究表明,MT后立即进行的DE-CT显示的SAIL与梗死体积扩大和MBE有关。
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来源期刊
CiteScore
9.50
自引率
14.60%
发文量
291
审稿时长
4-8 weeks
期刊介绍: The Journal of NeuroInterventional Surgery (JNIS) is a leading peer review journal for scientific research and literature pertaining to the field of neurointerventional surgery. The journal launch follows growing professional interest in neurointerventional techniques for the treatment of a range of neurological and vascular problems including stroke, aneurysms, brain tumors, and spinal compression.The journal is owned by SNIS and is also the official journal of the Interventional Chapter of the Australian and New Zealand Society of Neuroradiology (ANZSNR), the Canadian Interventional Neuro Group, the Hong Kong Neurological Society (HKNS) and the Neuroradiological Society of Taiwan.
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