易感血管征象作为颅内大血管闭塞的预测因子

Aiswarya Raj, Ashraf V. Valappil, Paul Johny, Paul J. Alapatt, K. P. Abdurehiman, L. K. Sreevidya, Noufal Basheer
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摘要

敏感性血管征象(SVS)可以在敏感性加权成像(SWI)上看到,通常被描述为暗盛开伪影。目的在T2*加权梯度回波成像中可见的SVS通常被描述为暗盛开伪影。因此,在成像上,低信号血管的直径比对面血管的直径大。我们对156例急性脑卒中患者进行了一项研究,以调查颅内主要动脉SWI体征的可靠性,并对这些患者使用改良Rankin量表(mRS)评估3个月的预后。结果106例磁共振血管造影(MRA)大血管闭塞(LVO)患者中,磁共振成像(MRI) SVS阳性73例,阴性33例。50例无LVO的患者中,SVS假阳性仅4例,SVS阴性46例。SVS作为筛查工具的敏感性、特异性、阳性预测值和阴性预测值在前循环LVO中分别为67.05%、90.7%、93.65%和57.35%,在后循环LVO中分别为77.8%、100%、100%和63.6%。卡方检验显示p <.05,表明显著相关。改良脑梗死溶栓(mTICI)评分为2B或3分时,83.3%的svs阳性患者成功再通,而64.4%的患者mRS评分小于3分。SVS是颅内LVO存在的良好筛查工具,敏感性好,特异性高,对LVO具有阳性的预测价值(后验>前)。SVS阳性也可能表明再通成功和90天mRS结果良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Susceptibility Vessel Sign as a Predictor of Intracranial Large Vessel Occlusion
Background The susceptibility vessel sign (SVS), which can be seen on susceptibility-weighted imaging (SWI), is typically described as a dark blooming artifact. Objective SVS, which can be seen on T2*-weighted gradient echo imaging, is typically described as a dark blooming artifact. The hypointense vessel’s diameter is thus larger on imaging than the opposing vessel’s diameter. We conducted a study to investigate the reliability of this sign on SWI in the principal intracranial arteries in 156 individuals with acute stroke and to assess the 3-month outcome using the modified Rankin Scale (mRS) in these patients. Results Among the 106 patients with large vessel occlusion (LVO) on magnetic resonance angiography (MRA), 73 patients demonstrated a positive SVS on magnetic resonance imaging (MRI), while 33 patients did not. Among the 50 patients without LVO, only 4 patients showed a false-positive SVS, while 46 patients showed a negative SVS. The sensitivity, specificity, positive predictive value, and negative predictive value of SVS as a screening tool were 67.05%, 90.7%, 93.65%, and 57.35% in anterior circulation LVO, and 77.8%, 100%, 100%, and 63.6% in posterior circulation LVO, respectively. The chi-square test showed p < .05, demonstrating a significant association. With a modified thrombolysis in cerebral infarction (mTICI) score of 2B or 3, 83.3% of SVS-positive patients had a successful recanalization, while 64.4% had an mRS score of less than 3. Interpretation SVS is a good screening tool for the presence of intracranial LVO, with good sensitivity, high specificity, and positive predictive value for LVO (posterior > anterior). SVS positivity may also indicate successful recanalization and a good 90-day mRS outcome.
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