Stroke:血管内血栓切除术中自动测量的脑萎缩与结局

2019-09-28 xing.T MedSci原创

由此可见,通过自动测量的颅内CSF体积确定的脑萎缩与EVT患者的功能预后相关。如果在未来的研究中得到验证,则该简单、客观且自动的影像标记物可能会被整合到决策支持工具中,以改善共享的治疗决策。

血管血栓切除术(EVT)后可能性较大的预测缺血性卒中患者预后不良的方法可能会改善患者、家属和医生之间共同的治疗决策。近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员使用一种客观、自动化的方法来测量脑萎缩,并调查这是否与EVT患者的预后有关。

该研究招募了在单中心注册的连续就诊的EVT患者,研究人员用经过验证的U-Net和Hounsfield单位阈值的组合对脑部CT扫描进行细分。颅内脑脊液(CSF)体积用作脑萎缩的标志物,并按颅内总体积的比例进行计算。该研究的主要结局是功能独立性,定义为3个月改良的Rankin量表评分为0到2。

研究人员纳入了360例EVT患者,204(56.7%)位患者获得了功能独立性。CSF体积的平均值±SD为颅内总体积的9.0±4.7%。多变量回归表明,CSF体积增加与功能独立性降低相关(CSF体积每增加5%的OR=0.65;95%CI为0.48–0.89;P=0.007),并有较高的3个月改良Rankin量表评分( CSF体积每增加5%OR可增加1.59%;95%CI为1.05-2.41;P=0.03)。

由此可见,通过自动测量的颅内CSF体积确定的脑萎缩与EVT患者的功能预后相关。如果在未来的研究中得到验证,则该简单、客观且自动的影像标记物可能会被整合到决策支持工具中,以改善共享的治疗决策。 

原始出处:

William K. Diprose.et al.Automated Measurement of Cerebral Atrophy and Outcome in Endovascular Thrombectomy.stroke.2019.https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.027120

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    2020-02-09 chendoc252
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    2019-09-28 一天没事干

    很好的学习机会

    0

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