CT灌注成像参数对急性前循环大血管闭塞血管内治疗患者预后的预测价值

Predictive Value of CT Perfusion Imaging Parameters for the Prognosis of Patients Treated Endovascularly for Acute Anterior Circulation Large Vessel Occlusion

目的 探讨采用RAPID软件处理的CT灌注成像(CTP)相关参数对急性前循环大血管闭塞血管内治疗(EVT)患者预后的预测价值。方法 共纳入118例患者,根据术后90天改良Rankin量表(mRS)评分,分为预后良好组(mRS≤2分)和预后不良组(mRS>2分),将两组患者一般资料及CTP相关参数进行比较并筛选预后影响因素。结果 年龄(OR=0.878,95%CI:0.817~0.943)、基线美国国立卫生研究院卒中量表(NIHSS)评分(OR=0.856,95%CI:0.764~0.959)、核心梗死体积区域(V_(CBF)<30)(OR=0.922,95%CI:0.887~0.958)、低灌注强度比值(HIR)(OR=0.018,95%CI:0.002~0.131)是急性前循环大血管闭塞EVT患者预后的独立影响因素(P<0.05)。结论 年龄、基线NIHSS评分、V_(CBF)<30、HIR是急性前循环大血管闭塞EVT患者预后不良的独立影响因素,CTP相关参数可用来预测急性前循环大血管闭塞EVT患者的预后。

Objective The objective of this study is to investigate the predictive value of CT perfusion imaging(CTP)-related parameters processed using RAPID software for the prognosis of patients undergoing endovascular treatment(EVT)for acute anterior circulation large vessel occlusion.Methods A total of 118 patients were included and divided into a good prognosis group(mRS≤2 points)and a poor prognosis group(mRS>2 points)according to the modified Rankin Scale(mRS)score at 90 days postoperatively.General data and CTP-related parameters of the two groups were compared and screened for prognostic factors.Results Age[OR=0.878(0.817-0.943)],baseline NIHSS score[OR=0.856,95%CI(0.764-0.959)],V_(CBF)<30[OR=0.922,95%CI(0.887-0.958)],and HIR[OR=0.018,95%CI(0.002-0.131)]were independent influences on the prognosis of EVT patients(P<0.05).Conclusion Age,baseline NIHSS score,V_(CBF)<30,and HIR are independent influences on poor prognosis in patients treated endovascularly for acute anterior circulation large vessel occlusion.It has been demonstrated that CTP-related parameters can be used to predict the prognosis of patients treated EVT for acute anterior circulation large vessel occlusion.