IF 4.9 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Guangchen He, Runjianya Ling, Liming Wei, Haitao Lu, Yi Gu, Yueqi Zhu
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引用次数: 0

摘要

区分颅内动脉粥样硬化性狭窄相关大血管闭塞(ICAS-LVO)和栓塞相关 LVO 的最佳神经影像学模式仍不确定。本研究旨在通过直接比较基线 CT 灌注(CTP)或多相 CT 血管造影(mCTA)来定义侧支循环,从而解决这一问题。我们回顾性分析了 2021 年 10 月至 2023 年 12 月期间连续收治的急性大血管闭塞患者。所有患者在接受血管内治疗前都接受了 CTP,而 mCTA 是根据 CTP 数据重建的。原位 ICAS-LVO 由神经介入放射科医生确认。良好的侧支循环被定义为侧支指数 P = 0.681)。相比之下,侧支指数为 P = 0.037 的侧支循环较好。)亚组分析表明,侧支分级≥3级可能无法预测6小时内的ICAS-LVO,而CTP在早期和晚期窗口期的预测性能始终很强。CTP 界定了侧支指数≥3 的有利侧支。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
CTP-defined collaterals is a better predictor of intracranial atherosclerotic stenosis-related large-vessel occlusion than multiphase CTA-defined collaterals.

The optimal neuroimaging modalities for differentiating intracranial atherosclerotic stenosis-related large vessel occlusion (ICAS-LVO) from embolism related LVO remain uncertain. This study aimed to address this question by directly comparing collateral circulation using either baseline CT perfusion (CTP) or multiphase CT angiogram (mCTA) to define collaterals. We retrospectively analyzed consecutive patients with acute large vessel occlusion from October 2021 to December 2023. All patients underwent CTP before endovascular therapy, and mCTA was reconstructed from CTP data. In-situ ICAS-LVO was confirmed by a neuro-interventional radiologist. Favorable collateral circulation was defined as a collateral index <0.4 on CTP or a collateral score ≥3 on mCTA. Of 377 patients, 72 (19%) had ICAS-LVO. Patients with only a collateral score ≥3 did not show significantly higher odds of ICAS-LVO (P = 0.681). In contrast, those with a collateral index <0.4 but not favorable mCTA collateral had higher odds of ICAS-LVO (OR2.69, 95%CI [1.07-7.01], P = 0.037). Subgroup analysis showed that a collateral grading scale ≥3 may not predict ICAS-LVO within 6 hours, whereas CTP's predictive performance remained consistently strong in both early and late windows. CTP defined favorable collaterals of collateral index <0.4 demonstrate greater predictive value for ICAS-LVO compared to mCTA, especially within an early time window.

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来源期刊
Journal of Cerebral Blood Flow and Metabolism
Journal of Cerebral Blood Flow and Metabolism 医学-内分泌学与代谢
CiteScore
12.00
自引率
4.80%
发文量
300
审稿时长
3 months
期刊介绍: JCBFM is the official journal of the International Society for Cerebral Blood Flow & Metabolism, which is committed to publishing high quality, independently peer-reviewed research and review material. JCBFM stands at the interface between basic and clinical neurovascular research, and features timely and relevant research highlighting experimental, theoretical, and clinical aspects of brain circulation, metabolism and imaging. The journal is relevant to any physician or scientist with an interest in brain function, cerebrovascular disease, cerebral vascular regulation and brain metabolism, including neurologists, neurochemists, physiologists, pharmacologists, anesthesiologists, neuroradiologists, neurosurgeons, neuropathologists and neuroscientists.
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