急性缺血性卒中患者的CT灌注成像：发病前他汀类药物治疗的作用。

IF 2.2 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Tomography Pub Date : 2025-05-06 DOI:10.3390/tomography11050054

Eliseo Picchi, Francesca Di Giuliano, Noemi Pucci, Fabrizio Sallustio, Silvia Minosse, Alfredo Paolo Mascolo, Federico Marrama, Valentina Ferrazzoli, Valerio Da Ros, Marina Diomedi, Massimo Federici, Francesco Garaci

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引用次数: 0

摘要

背景：他汀类药物似乎对急性缺血性脑卒中患者有用。我们的目的是评估发病前他汀类药物治疗与急性缺血性脑卒中CT灌注特征之间的关系。方法：回顾性分析前循环大血管闭塞的急性卒中患者，通过CT血管造影和CT灌注图评估侧支血流、缺血性核心体积和缺血性半暗区。采用Fisher精确检验比较两组患者的基线特征。使用独立组的Wilcoxon秩和检验来比较两个不同组使用和不使用他汀类药物的所有变量。结果：我们确定了61例患者，包括29例接受他汀类药物治疗和32例未接受他汀类药物治疗的患者，这些患者在卒中发作前与年龄、性别和血管危险因素（高胆固醇血症除外）相匹配。他汀类药物组发病时美国国立卫生研究院卒中量表评分较低(14±6.1比16±4.5；p = 0.04)，脑组织体积较小，表现为脑血流量（CBF）、脑血容量（CBV）和Tmax9.5-25s受损；另外，两组Tmax16-25s的体积差异无统计学意义。结论：发病前他汀类药物治疗与急性缺血性卒中在缺血性核心和缺血性半暗区体积方面的良好影像学状况有关。

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CT Perfusion Imaging in Patients with Acute Ischemic Stroke: The Role of Premorbid Statin Treatment.

Background: Statins appear to be useful in patients with acute ischemic stroke. Our aim was to evaluate the association between premorbid statin treatment and CT perfusion characteristics of acute ischemic stroke.

Methods: A retrospective analysis of patients with acute stroke secondary to occlusion of large vessels in the anterior circulation was performed to assess collateral flow, ischemic core volume, and ischemic penumbra using CT angiography and CT perfusion maps. Fisher's exact test was used to compare baseline characteristics of patients in the two groups. The Wilcoxon rank-sum test for independent groups was used to compare all variables obtained for the two different groups with and without statin use.

Results: We identified 61 patients, including 29 treated with statins and 32 not treated with statins before stroke onset matched by age, gender, and vascular risk factors except for hypercholesterolemia. The statin group showed lower National Institutes of health Stroke Scale scores at onset (14 ± 6.1 vs. 16 ± 4.5; p = 0.04) and lower volumes of brain tissue characterized by impaired cerebral blood flow (CBF), cerebral blood volume (CBV), and Tmax9.5-25s; otherwise, no statistically significant difference was found in the volume of the Tmax16-25s between the two groups.

Conclusions: Premorbid statin treatment is associated with a favorable imaging condition of acute ischemic stroke in terms of ischemic core and ischemic penumbra volume.

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来源期刊

Tomography Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

2.70

自引率

10.50%

发文量

222

期刊介绍： TomographyTM publishes basic (technical and pre-clinical) and clinical scientific articles which involve the advancement of imaging technologies. Tomography encompasses studies that use single or multiple imaging modalities including for example CT, US, PET, SPECT, MR and hyperpolarization technologies, as well as optical modalities (i.e. bioluminescence, photoacoustic, endomicroscopy, fiber optic imaging and optical computed tomography) in basic sciences, engineering, preclinical and clinical medicine. Tomography also welcomes studies involving exploration and refinement of contrast mechanisms and image-derived metrics within and across modalities toward the development of novel imaging probes for image-based feedback and intervention. The use of imaging in biology and medicine provides unparalleled opportunities to noninvasively interrogate tissues to obtain real-time dynamic and quantitative information required for diagnosis and response to interventions and to follow evolving pathological conditions. As multi-modal studies and the complexities of imaging technologies themselves are ever increasing to provide advanced information to scientists and clinicians. Tomography provides a unique publication venue allowing investigators the opportunity to more precisely communicate integrated findings related to the diverse and heterogeneous features associated with underlying anatomical, physiological, functional, metabolic and molecular genetic activities of normal and diseased tissue. Thus Tomography publishes peer-reviewed articles which involve the broad use of imaging of any tissue and disease type including both preclinical and clinical investigations. In addition, hardware/software along with chemical and molecular probe advances are welcome as they are deemed to significantly contribute towards the long-term goal of improving the overall impact of imaging on scientific and clinical discovery.