多模态CT预测前循环急性缺血性卒中患者经机械取栓后出血性转化

Multimodal CT for predicting hemorrhagic transformation after mechanical thrombectomy in patients with anterior circulation acute ischemic stroke

目的观察多模态CT预测前循环急性缺血性卒中(AIS)患者经机械取栓后出血性转化(HT)的价值。方法回顾性分析88例接受机械取栓治疗的前循环AIS患者,根据治疗后发生HT与否分为HT组(n=26)与非HT组(n=62);比较组间临床及CT资料,筛选HT影响因素并建立模型,观察其预测前循环AIS机械取栓后HT的效能。结果组间基线美国国立卫生研究院卒中量表(NIHSS)评分、责任血管、Alberta卒中项目早期CT评分(ASPECTS)及相对流量提取乘积(rFEP)差异均有统计学意义(P均<0.05);责任血管、ASPECTS及rFEP均为前循环AIS机械取栓后HT的独立影响因素(P均<0.05)。基于此建立的列线图模型预测前循环AIS机械取栓后HT的曲线下面积为0.866[95%CI(0.790,0.942)]。结论多模态CT所示责任血管、ASPECTS及rFEP有助于预测前循环AIS患者经机械取栓后HT。

Objective To observe the value of multimodal CT for predicting hemorrhagic transformation(HT)after mechanical thrombectomy in patients with anterior circulation acute ischemic stroke(AIS).Methods Data of 88 patients with anterior circulation AIS who underwent mechanical thrombectomy were retrospectively analyzed.The patients were divided into HT group(n=26)and non-HT group(n=62)according to HT occurred or not after mechanical thrombectomy.Clinical data and CT findings were compared between groups,and the influencing factors of HT were screened.Then a model was established,and its value for predicting HT after mechanical thrombectomy in anterior circulation AIS patients was analyzed.Results Significant differences of baseline National Institutes of Health Stroke Scale(NIHSS)scores,responsible vessels,Alberta stroke program early CT scores(ASPECTS)and relative flow extraction products(rFEP)were found between groups(all P<0.05).The responsible vessel,ASPECTS and rFEP were all independent influencing factors of HT after mechanical thrombectomy in anterior circulation AIS patients(all P<0.05).The area under the curve of the nomogram model established bases on the above indexes for predicting HT after mechanical thrombectomy in anterior circulation AIS patients was 0.866(95%CI[0.790,0.942]).Conclusion The responsible vessel,ASPECTS and rFEP showed on multimodal CT were helpful for predicting HT in anterior circulation AIS patients after mechanical thrombectomy.