转移后CT成像中的延迟频谱征象:脑卒中严重程度和出血风险的影像学标记。

IF 2.6 3区 医学 Q2 CLINICAL NEUROLOGY
Edwin Gulko, Sheldon Lerman, Eris Spirollari, Sabrina Zeller, Monica Mureb, John Wainwright, Akihiko Oishi, Anoosh Kouyoumdjian, Kevin Clare, Anna Rozenshtein, Fawaz Al-Mufti, Chirag Gandhi, Hasit Mehta
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引用次数: 0

摘要

目的:急性脑卒中转移患者在到达血栓切除中心后经常接受重复的计算机断层扫描(CT)成像。通常,残留的静脉(IV)“对比染色”急性梗死在最初的转移后CT头部检查,我们已经检测到利用双层CT光谱虚拟非对比图像。我们称之为延迟谱号(DSS)。我们试图测量转移后首次CT头部检查中DSS的发生率,并评估任何相关的临床结果。方法:我们对急性脑卒中转移患者进行回顾性研究,这些患者在转移后首次CT频谱扫描仪头部检查中发现残留静脉造影剂。两名神经放射学家独立回顾了CT头部检查和虚拟非对比图像,以测量DSS的发生率。分析数据以评估DSS组与非DSS组之间的显著差异。结果:67例急性脑卒中转移患者符合纳入标准,其中8例(11.9%)表现为DSS。DSS患者更容易发生大血管闭塞(100% vs. 64.4%, P = 0.049)和M1大脑中动脉(MCA)闭塞(OR 4.9, P = 0.046)。DSS患者在随访CT或MRI检查中颅内出血的发生率更高(or 9.259, P = 0.008)。DSS患者出院时的NIHSS评分(22.25±18.3)高于其他患者(P = 0.079),但差异无统计学意义。在多因素回归分析中,住院随访CT或MRI显示DSS与颅内出血呈正相关(or 9.683, P = 0.012)。结论:迟发光谱征象与后续头颅影像学大血管闭塞及颅内出血的发生率相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The delayed spectral sign in Post-transfer CT imaging: an imaging marker of stroke severity and hemorrhagic risk.

Purpose: Acute stroke transfer patients often undergo repeat computed tomography (CT) imaging upon arrival at a thrombectomy-capable center. Often, there is residual intravenous (IV) "contrast staining" of acute infarcts on the initial post-transfer CT head exam, which we have detected utilizing dual-layer CT spectral virtual non-contrast images. We term this the delayed spectral sign (DSS). We sought to measure the incidence of the DSS on initial post-transfer CT head exams and evaluate for any associated clinical outcomes.

Methods: We performed a retrospective study of acute stroke transfer patients with residual IV contrast on initial post-transfer CT spectral scanner head exams. Two neuroradiologists independently reviewed CT head exams and virtual non-contrast images to measure the incidence of the DSS. Data was analyzed to evaluate significant differences between DSS and non-DSS groups.

Results: 67 acute stroke transfer patients met inclusion criteria, of whom 8 (11.9%) demonstrated the DSS. Patients with the DSS were more likely to have a large vessel occlusion (100% vs. 64.4%, P = 0.049) and an M1 middle cerebral artery (MCA) occlusion (OR 4.9, P = 0.046). DSS patients had a greater prevalence of intracranial hemorrhage on follow-up CT or magnetic resonance imaging (MRI) exams (OR 9.259, P = 0.008). DSS patients had a higher average National Institute of Health Stroke Scale (NIHSS) upon discharge (22.25 ± 18.3), although this was not statistically significant (P = 0.079). In multivariate regression analyses, DSS was positively associated with intracranial hemorrhage on inpatient follow-up CT or MRI (OR 9.683, P = 0.012).

Conclusion: The delayed spectral sign is associated with greater incidences of large vessel occlusions and intracranial hemorrhage on follow-up head imaging.

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来源期刊
Neuroradiology
Neuroradiology 医学-核医学
CiteScore
5.30
自引率
3.60%
发文量
214
审稿时长
4-8 weeks
期刊介绍: Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.
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