急性缺血性脑卒中的临床放射学变量与发病到显像时间的关系：一项回顾性研究

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-08-05 DOI:10.1016/j.jstrokecerebrovasdis.2025.108410

Bafrin Abdulmajid , Laura M. van Poppel , Charles B.L.M. Majoie , Bart J. Emmer , Henk A. Marquering , MR CLEAN Investigators

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引用次数: 0

摘要

背景：许多急性缺血性脑卒中（AIS）患者的发病时间未知。这些患者需要先进的影像学检查或有时被排除在治疗之外。我们研究了临床放射学变量（通过非对比计算机断层扫描（NCCT）和CT血管造影（CTA）评估）与MR CLEAN登记（血管内治疗（EVT）登记）中AIS患者的发病至成像时间之间的关系。方法我们从MR CLEAN Registry中纳入4003例AIS患者。患者分为早期(≤4.5 h；≤6h)或晚(>4.5 h；> 6h)发病到成像时间窗。单变量和多变量logistic回归评估了基线临床放射学变量与发病至影像学时间之间的关系。采用受试者工作特征（ROC）曲线分析评价准确度。结果在多变量logistic回归中，阿尔伯塔卒中计划早期CT评分（ASPECTS）（OR 0.90, 95% CI 0.84-0.97）、白质变的存在（OR 1.51, 95% CI 1.19-1.92）、中度（OR 2.53, 95% CI 1.16-5.54）和良好（OR 3.90, 95% CI 1.76-8.66）侧部评分与4.5 h的发病至显像时间显著相关。方面（OR 0.89, 95% CI 0.81-0.98）、白质变的存在（OR 1.55, 95% CI 1.14-2.11）和良好的侧支评分（OR 3.31, 95% CI 1.17-9.39）与6小时的发病到显像时间显著相关。在>；4.5 h和>；6 h时间窗下，ROC曲线下面积均为0.63。在MR CLEAN登记的AIS患者中，较低的ASPECTS、白质变的存在和较高的侧支评分与较晚的发病至成像时间(4.5 h；中风发作后6小时)。临床放射学变量与发病至影像学时间之间关联的准确性较差。

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Associations between clinicoradiological variables and onset-to-imaging time in acute ischemic stroke: A retrospective study

Background

Many acute ischemic stroke (AIS) patients have an unknown onset time. These patients require advanced imaging or are sometimes excluded from treatment. We investigated the associations between clinicoradiological variables, as assessed with non-contrast computed tomography (NCCT) and CT angiography (CTA), and onset-to-imaging time in AIS patients included in the MR CLEAN registry, an endovascular treatment (EVT) registry.

Methods

We included 4003 AIS patients from the MR CLEAN Registry. Patients were classified as in the early (≤4.5 h; ≤6 h) or late (>4.5 h; >6 h) onset-to-imaging time windows. Univariable and multivariable logistic regression assessed associations between baseline clinicoradiological variables and onset-to-imaging time. Accuracy was evaluated using receiver operating characteristic (ROC) curve analyses.

Results

In multivariable logistic regression, Alberta Stroke Program Early CT Score (ASPECTS) (OR 0.90, 95 % CI 0.84-0.97), presence of leukoaraiosis (OR 1.51, 95 % CI 1.19-1.92), and moderate (OR 2.53, 95 % CI 1.16-5.54) and good (OR 3.90, 95 % CI 1.76-8.66) collateral score were significantly associated with an >4.5 h onset-to-imaging time. ASPECTS (OR 0.89, 95 % CI 0.81-0.98), presence of leukoaraiosis (OR 1.55, 95 % CI 1.14-2.11), and a good (OR 3.31, 95 % CI 1.17-9.39) collateral score were significantly associated with an >6 h onset-to-imaging time. Area under the ROC curves was 0.63 for both the >4.5 h and >6 h time windows.

Conclusion

Among AIS patients included in the MR CLEAN registry, lower ASPECTS, presence of leukoaraiosis and a higher collateral score are associated with a late onset-to-imaging time (>4.5 h; >6 h after stroke onset). The accuracy of the association between clinicoradiological variables and onset-to-imaging time is poor.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.