脑实质强化程度预测急性前循环大血管闭塞性脑梗死血管内治疗后出血转化风险研究

目的 评估急性前循环大血管闭塞性脑梗死血管内治疗术后CT平扫脑实质强化程度预测出血转化(hemorrhagic transformation,HT)的临床价值.方法 连续收集2017年1月-2019年9月在威海市中心医院及兰陵县人民医院卒中中心接受血管内治疗的急性前循环大血管闭塞性脑梗死患者的影像学资料.根据术后即刻头...

Brain Parenchymal Enhancement Predicts Hemorrhagic Transformation after Endovascular Treatment in Acute Cerebral Infarction with Anterior Circulation Large Vessel Occlusion

Objective To evaluate the clinical value of cerebral parenchymal enhancement in predicting hemorrhagic transformation(HT)after endovascular therapy in acute cerebral infarction with anterior circulation large vessel occlusion.Methods A retrospective analysis was performed for the clinical data of the patients with anterior circulation large vessel occlusion who underwent endovascular treatment in Stroke Center of Weihai Central Hospital and the People's Hospital of Lanling from January 2017 to September 2019.Brain parenchymal enhancement was assessed by contrast extravasation on head CT scan immediately after endovascular therapy,which reflects blood brain barrier damage.According to the enhancement degree,all the patients were divided into mild and no enhancement group and moderate and severe enhancement group.All the patients underwent head CT scan at 24-36 hours after surgery to evaluate intracranial hemorrhage.The relationship between brain parenchymal enhancement and HT was analyzed.Based on preoperative CTP,the difference in permeability surface(PS)between the lesion side and health side in moderate and severe enhancement group and the relative PS(rPS)between mild and no enhancement group and moderate and severe enhancement group were compared.Results A total of 30 patients were included.7(50.0%)of 14 patients in moderate and severe enhancement group developed HT,and 1(6.3%)of 16 patients in mild and no enhancement group developed HT(P=0.04).The PS of the lesion side was higher than that of health side in moderate and severe enhancement group[2.99(2.90-3.10)mL/(100 g·min)vs 2.00(1.97-2.33)mL/(100 g·min),P=0.01],and the rPS in moderate and severe enhancement group was higher than that in mild and no enhancement group(1.44±0.28 vs 1.10±0.07,P=0.01),both the difference were statistically significant.Conclusions Cerebral parenchymal enhancement signal on CT immediately after endovascular therapy can be a valuable imaging biomarker for predicting HT in acute cerebral infarction with anterior circulation large vessel occlusion.