通讯作者: 朱东胜, 837119941@qq.com

DOI：10.12201/bmr.202503.00006

Imaging factor analysis of reversible ischemic lesionin cranial CT after mechanical thrombectomy for acute anterior circulation large vessel occlusion

• 摘要：目的 探讨急性前循环大血管闭塞脑卒中（acute anterior circulation large vessel occlusive stroke,ALVOS）机械取栓(mechanical thrombectomy,MT)术后颅脑CT可逆性缺血性水肿的影响因素。 方法 纳入2022年06月至2024年07月于嘉兴市第一医院神经内科住院的ALVOS行MT患者，术后颅脑CT评估有无可逆性缺血性水肿，收集患者的基线临床资料。采用多因素logistic回归模型分析ALVOS行MT术后颅脑CT可逆性缺血性水肿的独立危险因素；构建受试者工作特征（ROC）曲线，评估其对ALVOS行MT术后颅脑CT可逆性缺血性水肿的预测价值。结果 研究纳入患者142例，不可逆缺血性水肿组120例；可逆性缺血性水肿组22例，其发生率15.5%。二元多因素logistic回归分析结果显示，年龄（OR=1.111，95%CI：1.017，1.241，P=0.031）和发病至穿刺时间（OR=1.050，95%CI：1.030，1.086，P=0.001）是ALVOS行EVT术后颅脑CT可逆性缺血性水肿的独立危险因素。ROC曲线分析结果显示，年龄、发病至穿刺时间对ALVOS行MT术后颅脑CT可逆性缺血性水肿的预测价值较好，曲线下面积=0.989，敏感度为93.3%，特异度为100%。结论 ALVOS行MT术后颅脑CT上缺血区域低密度可能是可逆的，MT患者年龄较轻、发病至穿刺时间较短可能与术后颅脑CT可逆性缺血性水肿有关。

  关键词： 脑梗死；机械取栓；颅脑CT；可逆性；缺血性水肿

   

  Abstract: Objective To explore the imaging factor analysis of reversible ischemic edema on cranial CT after mechanical thrombectomy（MT） for acute anterior circulation large vessel occlusion(ALVOS). Methods Patients with ALVOS who underwent MT and were admitted to the Department of Neurology of Jiaxing First Hospital from June 2022 to July 2024 were collected. Cranial CT was used to assess the presence of reversible ischemic edema after the operation. Baseline clinical data of the patients were collected. Multivariate logistic regression model was used to analyze the independent risk factors for reversible ischemic edema on cranial CT after MT for ALVOS; receiver operating characteristic (ROC) curve was constructed to evaluate its predictive value for reversible ischemic edema on cranial CT after MT for ALVOS. Results A total of 142 patients were included in the study, with 120 cases in the irreversible ischemic edema group and 22 cases in the reversible ischemic edema group, with an incidence rate of 15.5%. Binary multivariate logistic regression analysis showed that age (OR = 1.111, 95% CI: 1.017, 1.241, P = 0.031) and time from onset to puncture (OR = 1.050, 95% CI: 1.030, 1.086, P = 0.001) were independent risk factors for reversible ischemic edema on cranial CT after MT for ALVOS. ROC curve analysis showed that age and time from onset to puncture had good predictive value for reversible ischemic edema on cranial CT after MT for ALVOS,area under the curve = 0.989, sensitivity was 93.3%, specificity was 100%. Conclusion The low-density area in the ischemic region on cranial CT after MT for ALVOS may be reversible. Younger age and shorter time from onset to puncture in MT patients may be related to reversible ischemic edema on cranial CT after the operation.

  Key words: Stroke；Mechanical Thrombectomy；Cranial CT；Reversible；Ischemic lesioni

  提交时间：2025-03-03

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• 序号	提交日期	编号	操作
  1	2025-01-22	bmr.202503.00006V1	下载

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