摘要
目的 探讨基于4D-CTA改良ASITN/SIR侧支循环评分与急性缺血性脑卒中患者预后的相关性。方法 收集2021年1月至2021年12月我院收治的41例因单侧大脑中动脉重度狭窄或闭塞而发生急性脑血管事件的患者,入院后行脑部4D-CTA和DSA检查,以DSA的ASITN/SIR评分作为金标准,评价4D-CTA改良ASITN/SIR侧支循环评分方法的效能,并分析该评分与急性缺血性脑卒中患者预后的相关性。结果 依据随访3个月的mRS评分分为两组,预后良好组(n=27)与预后不良组(n=14)之间患者糖尿病史、卒中史以及入院时NIHSS评分的差异有统计学意义(P<0.05)。采用ROC曲线分析,4D-CTA改良ASITN/SIR侧支循环评分的AUC值为0.959(95%置信区间:0.855~0.998,P<0.001)。改良ASITN/SIR评分对急性缺血性脑卒中患者预后的阳性预测值为80.0%、阴性预测值为92.3%,该评分与随访三个月后mRS评分呈负相关(r=-0.899,P<0.001)。结论 4D-CTA改良ASITN/SIR评分能准确评估急性缺血性脑卒中患者侧支循环和预测预后,为治疗方案提供重要依据。
Objective To explore the correlation between modified ASITN/SIR collateral circulation score based on 4D-CTA and prognosis of patients with acute ischemic stroke.Methods 41 patients with acute ischemic stroke with severe stenosis or occlusion of unilateral middle cerebral artery were collected from January 2021 to December 2021.Brain 4D-CTA and DSA were performed after admission.ASITN/SIR score of DSA was used as the gold standard to evaluate the efficacy of modified ASITN/SIR score of 4D-CTA collateral circulation,and the correlation between this score and the prognosis of patients with acute ischemic stroke was analyzed.Results According to the mRS score of 3-month follow-up,there were significant differences in diabetes history,stroke history and NIHSS score on admission between the good prognosis group(n=27)and the poor prognosis group(n=14).Using ROC curve analysis,the AUC value of the modified ASITN/SIR score of 4D-CTA collateral circulation was 0.959(95%confidence interval:0.855~0.998,P<0.001).The positive predictive value of the modified ASITN/SIR score for the prognosis of acute ischemic stroke patients was 80.0%,and the negative predictive value was 92.3%.The score was negatively correlated with the mRS score after three months of follow-up(r=-0.899,P<0.001).Conclusion 4D-CTA modified ASITN/SIR score can accurately evaluate collateral circulation and predict prognosis in patients with acute ischemic stroke,which provides an important basis for treatment.
作者
李贞
梁奕
石敏
杨威威
范文辉
LI Zhen;LIANG Yi;SHI Min;YANG Wei-wei;FAN Wen-hui(Department of Radiology,General Hospital of The Yangtze River Shipping,Wuhan Brain Hospital,Wuhan 430010,Hubei Province,China)
出处
《中国CT和MRI杂志》
2023年第5期15-17,共3页
Chinese Journal of CT and MRI
基金
武汉市卫生健康委科研计划资助项目(WX20C25)。