本文已被：浏览 1633次 下载 482次
投稿时间：2022-06-19 网络发布日期：2023-03-20
投稿时间：2022-06-19 网络发布日期：2023-03-20
中文摘要: 目的 评估磁共振弥散加权成像（DWI）皮质花边征与机械取栓预后之间的关系，探讨DWI皮质花边征在筛选急性缺血性脑卒中适合取栓患者中的可靠性。方法 回顾性分析2018年1月至2021年10月在西安交通大学第一附属医院（15例）、西电集团医院（12例）、咸阳市第一人民医院（8例）、西安大兴医院（10例）和西安市中心医院（5例）行取栓手术并成功再通的（改良脑梗死溶栓评分2b及3级）急性缺血性脑卒中患者的术前DWI特点，DWI皮质花边征定义为扩散受限的高信号在皮质表面或脑回表面条带状走形，分析有无皮质花边征对临床预后的影响。结果 共50例患者纳入分析，其中30例DWI具有皮质花边征，20例无皮质花边征，两组患者在年龄、性别、入院NIHSS评分、ASPECT评分、发病原因、发病至入院时间、发病至穿刺时间及穿刺到血管成功再通时间差异均无统计学意义（P＞0.05）。DWI皮质花边征组90 dmRS≤2分的比率明显高于无皮质花边征组（60.0% vs25.0%，P＜0.05），而术后恶性脑水肿比率明显低于无皮质花边征组（10.0% vs 45.0%，P＜0.05）。结论 DWI皮质花边征与取栓的良好的预后有关，可以作为影像筛选急性缺血性脑卒中适合取栓患者的一种简易模式。
Abstract:Objective To evaluate the relationship between cortical ribbon sign in magnetic resonance diffusion weighted imaging (DWI) and prognosis of mechanical thrombectomy to explore the reliability of DWI cortical ribbon sign for screening in patients with acute ischemic stroke (AIS) suitable for thrombectomy. Methods A retrospective analysis was performed on the preoperative DWI characteristics of 50 AIS patients undergoing thrombectomy with successful recanalization ［modified thrombolysis in cerebral infarction (mTICI)2b/3］ in the First Affiliated Hospital of Xi'an Jiaotong University (15 cases), Xidian Group Hospital (12 cases), Xianyang First People's Hospital (8 cases), Xi'an Daxing Hospital (10 cases) and Xi'an Central Hospital (5 cases) from January 2018 to October 2021. DWI cortical ribbon sign was defined as the banded shape of high signals with limited diffusion on cortical surface or gyrus surface, and the relationship between cortical ribbon sign and clinical prognosis was analyzed. Results There were 30 patients with DWI cortical ribbon sign (DWI cortical ribbon sign group) and 20 patients without cortical ribbon sign (cortical ribbon-free group) . There was no significant difference in age, gender, admission NIHSS score, ASPECT score, pathogenesis, time from onset to admission, time from stroke onset to puncture and time from puncture to successful recanalization between two groups (P＞0.05). The proportion of 90-day modified Rankin scale (mRS) score ≤2 in cortical ribbon sign group was significantly higher than that in cortical ribbon free group (60.0% vs25.0%, P＜0.05), while the incidence of postoperative malignant cerebral edema was significantly lower in cortical ribbon sign group than that in coritical ribbon free group (10.0% vs 45.0%, P＜0.05). Conclusion DWI cortical ribbon sign is related to the good prognosis of thrombectomy and can be used as a simple mode for image screening of AIS patients who are suitable or not for thrombectomy.
keywords: Acute ischemic stroke Endovascular therapy Mechanical thrombecotomy Magnetic resonance diffusion weighted imaging Cortical ribbon sign
文章编号： 中图分类号：R743.3 文献标志码：A
基金项目:陕西省中医药管理局科研项目（2021-ZZ-LC033）
附件
引用文本：
姚力,朱浩,李伟旺,等.DWI皮质花边征对急性缺血性脑卒中患者机械取栓预后的预测作用[J].中国临床研究,2023,36(3):343-346.
姚力,朱浩,李伟旺,等.DWI皮质花边征对急性缺血性脑卒中患者机械取栓预后的预测作用[J].中国临床研究,2023,36(3):343-346.