Tmax 10 Volume Is Independently Associated with NWU Delta in Large Core Stroke.

IF 2.6 3区医学 Q2 Medicine

Clinical Neuroradiology Pub Date : 2025-09-30 DOI:10.1007/s00062-025-01569-6

Vivek Yedavalli, Hamza Adel Salim, Dhairya A Lakhani, Aneri Balar, Janet Mei, Thanh N Nguyen, Adrien Guenego, Adam A Dmytriw, Jens Fiehler, Paul Stracke, Gabriel Broocks, Christian Heitkamp, Max Wintermark, Gregory W Albers, Jeremy J Heit, Tobias D Faizy

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引用次数: 0

Abstract

Background: In patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO) and large ischemic cores, there is a need for reliable imaging biomarkers to predict cerebral edema growth. We investigated the association between severely hypoperfused tissue, measured by time-to-maximum greater than 10 s (Tmax > 10 s) volume, and net water uptake (∆NWU) progression.

Methods: This multicenter retrospective cohort study involved AIS-LVO patients with ASPECTS ≤ 5, undergoing EVT at two comprehensive stroke centers between January 2013 and December 2019. We investigated the relationship between Tmax > 10 s volume derived from perfusion imaging and ∆NWU measured on non-contrast head CT images, hypothesizing that larger Tmax > 10 s volumes are indicative of greater edema growth in large core strokes.

Results: A total of 95 patients (median age, 74 years; 55% women) were included. After adjustment for age, sex, glucose, intravenous thrombolysis, admission NIHSS, ASPECTS, Tan collateral score, last known well-to-CT time, and EVT, higher Tmax > 10 s volume (β, -0.34; P = 0.043) and lower ASPECTS (β, -0.30; P = 0.035) were independently associated with greater ∆NWU.

Conclusion: The study highlights the importance of considering severe pretreatment hypoperfusion, as reflected by larger Tmax > 10 s volumes, in predicting cerebral edema growth in AIS-LVO patients, which could inform clinical strategies, emphasizing the need for larger prospective studies to validate and explore implications.

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Tmax - 10体积与大核心中风的NWU Delta独立相关。

背景：在因大血管闭塞（AIS-LVO）和大缺血核心引起的急性缺血性卒中患者中，需要可靠的成像生物标志物来预测脑水肿的生长。我们研究了严重低灌注组织（以≥10 s （Tmax > 10 s）体积至最大时间测量）与净吸水（∆NWU）进展之间的关系。方法：本多中心回顾性队列研究纳入了2013年1月至2019年12月在两个卒中综合中心接受EVT治疗的ASPECTS≤ 5的AIS-LVO患者。我们研究了灌注成像得出的Tmax > 10 s体积与非对比头部CT图像测量的∆NWU之间的关系，假设较大的Tmax > 10 s体积表明大核心脑卒中水肿增长较大。结果：共纳入95例患者（中位年龄74岁，其中55%为女性）。在调整年龄、性别、血糖、静脉溶栓、入院NIHSS、ASPECTS、Tan侧支评分、最后已知距ct时间、EVT后，较高的Tmax > 10 s体积（β, -0.34; P = 0.043）和较低的ASPECTS （β, -0.30; P = 0.035）与较大的∆NWU独立相关。结论：该研究强调了在预测AIS-LVO患者脑水肿增长时考虑严重预处理低灌注的重要性，这反映在较大的Tmax > 10 体积上，这可以为临床策略提供信息，强调需要更大规模的前瞻性研究来验证和探索其影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neuroradiology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

4.90

自引率

3.60%

发文量

期刊介绍： Clinical Neuroradiology provides current information, original contributions, and reviews in the field of neuroradiology. An interdisciplinary approach is accomplished by diagnostic and therapeutic contributions related to associated subjects. The international coverage and relevance of the journal is underlined by its being the official journal of the German, Swiss, and Austrian Societies of Neuroradiology.