Stroke:磁共振成像预测急性缺血性脑卒中再灌注后脑血肿

2017-02-02 MedSci MedSci原创

急性缺血性卒中患者发生脑实质出血(PH)的风险增加,特别是在再灌注治疗的过程中。近期,一项发表在Stroke杂志上的研究开发了一个预测模型,模型使用组合磁共振灌注和扩散参数,包括脑血容量(CBV),表观弥散系数和微血管通透性(K2)来检查发生PH的风险。此项研究基于CBV,K2值的立体像素;使用参与MR RESCUE临床试验(使用栓子切除术的中风血栓的机械回缩和再通)的患者的预处理磁共振成像数据,

急性缺血性卒中患者发生脑实质出血(PH)的风险增加,特别是在再灌注治疗的过程中。


近期,一项发表在Stroke杂志上的研究开发了一个预测模型,模型使用组合磁共振灌注和扩散参数,包括脑血容量(CBV),表观弥散系数和微血管通透性(K2)来检查发生PH的风险。

此项研究基于CBV,K2值的立体像素;使用参与MR RESCUE临床试验(使用栓子切除术的中风血栓的机械回缩和再通)的患者的预处理磁共振成像数据,获得来自缺血性核的表观扩散系数。在单变量和多变量分析中评估了PH和成像参数的极值之间的关联。进行受试者工作特征曲线分析以确定预测PH的最佳参数和阈值。

此项研究结果显示:该分析中包括的83位患者中,20位发展为PH。单变量分析显示,在PH患者的梗死核心内,第10百分位的CBV和第10百分位数的表观弥散系数值明显较低,而第90百分位数的K2值明显较高。

使用分类树分析,阈值为0.47的第10百分位CBV和阈值为0.28的第90百分位数的K2的总预测准确性为88.7%,灵敏度为90.0%,特异性为87.3%,优于任何个体或组合的其他分类。

此项研究结果表明:联合第10百分位CBV和第90百分位K2是急性缺血性卒中患者发生PH的独立预测因子,诊断准确性优于单独的分类。

原始出处:
Nael K, Knitter JR, Jahan R, et al. Multiparametric Magnetic Resonance Imaging for Prediction of Parenchymal Hemorrhage in Acute Ischemic Stroke After Reperfusion Therapy. Stroke. 2017 Jan 30. pii: STROKEAHA.116.014343.

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    2017-02-20 lanqier2013

    这次还挺好的,把文章的出处给出来了

    0

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    2017-02-06 逃家小兔

    学习啦

    0

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    2017-02-03 Healer

    学习了。新的进展

    0

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