摘要
目的研究血管内治疗后的动脉再通与磁敏感血管征(susceptibility vessel sign,SVS)的长度和宽度之间的关系,评估血管内治疗后动脉成功再通与各种风险因素的关系。材料与方法回顾性分析接受血管内治疗前进行常规头颅磁共振成像(magnetic resonance imaging,MRI)和磁敏感加权成像(susceptibility-weighted imaging,SWI)检查的前循环缺血性脑卒中患者,并测量SVS的长度和宽度。为了减小不同部位和个体差异导致的SVS宽度变异,将患侧SVS宽度除以健侧血管的宽度,求得SVS相对宽度。血管内治疗结束时,扩展脑梗死溶栓分级(expanded thrombolysis in cerebral infarction,eTICI)评估达到2b50-3为成功再通组,未达到的为未成功再通组。采用逐步回归法筛选变量,并将差异有统计学意义的指标纳入多因素logistic回归分析,以确定血管内治疗后成功再通和首次通过再灌注(first-pass reperfusion,FPR)的独立预测因素。结果在112例患者当中,成功再通组79例,未成功再通组33例,成功再通组中FPR共39例。成功再通组和未成功再通组SVS的中位宽度分别为4.3(4.1,4.6)mm和3.2(3.0,3.9)mm,差异有统计学意义(P<0.001);SVS的中位长度分别为10.6(9.5,13.1)mm和10.5(7.5,14.5)mm,差异无统计学意义(P=0.871)。在多因素logistic回归分析中,SVS宽度与动脉成功再通[OR=3.025,95%置信区间(confidence interval,CI)为4.895~24.564,P=0.001]和FPR(OR=9.243,95%CI为3.493~14.460,P<0.001)存在显著相关。用于预测动脉成功再通和FPR的SVS宽度的最佳截断值分别为3.95 mm和3.85 mm。结论SVS的宽度是预测血管内治疗后动脉成功再通及FPR的潜在影像学标志物,SVS长度则无显著预测价值。
Objective:To investigate the relationship between arterial recanalization after endovascular treatment and the length and width of the susceptibility vessel sign(SVS),and to evaluate the relationship between successful arterial recanalization after endovascular treatment and various risk factors.Materials and Methods:We retrospectively analyzed the patients with anterior circulation ischemic stroke who underwent magnetic resonance imaging(MRI)of the head and susceptibility-weighted imaging(SWI)before endovascular treatment,and measured the SVS length and width.To reduce the variation of SVS width caused by different parts and individual differences,divide the width of the SVS on the affected side by the width of the healthy blood vessel to obtain the relative width of the SVS.At the end of endovascular treatment,those who achieved an assessment of 2b50-3 in the expanded thrombolysis in cerebral infarction(eTICI)were classified as the successful recanalization group,while those who did not reach this level were classified as the unsuccessful recanalization group.Stepwise regression was used to screen variables,and the indicators with statistically significant differences were included in the multivariate logistic regression analysis to determine the independent predictors of successful recanalization and first-pass reperfusion(FPR)after endovascular treatment.Results:Among 112 patients,79 cases achieved successful recanalization and 33 cases did not,within the successful recanalization group,there were 39 cases of FPR.The median width of SVS in the successful recanalization group and the unsuccessful recanalization group was 4.3(4.1,4.6)mm and 3.2(3.0,3.9)mm,respectively,with P<0.001,indicating a statistically significant difference;the median length of SVS was 10.6(9.5,13.1)mm and 10.5(7.5,14.5)mm,respectively,with P=0.871,indicating no statistically significant difference.In the multivariate logistic regression analysis,SVS width was associated with successful recanalization[odds ratio=3.025;95% confidence interval(CI):4.895 to 24.564;P=0.001]and FPR(odds ratio=9.243;95%CI:3.493 to 14.460;P<0.001).The optimal cutoff value for the SVS width to predict successful recanalization and FPR were 3.95mm and 3.85 mm,respectively.Conclusions:The width of SVS is a potential imaging biomarker for predicting successful reperfusion of arteries and FPR after endovascular treatment.The length of SVS has no significant predictive value.
作者
耿悦
张蜜
王卢佳慧
陈菊萍
李俊晨
钱芯
陈雨昂
谈炎欢
GENG Yue;ZHANG Mi;WANG Lujiahui;CHEN Juping;LI Junchen;QIAN Xin;CHEN Yu'ang;TAN Yanhuan(Department of Radiology,Changshu Hospital Affiliated to Nanjing University of Chinese Medicine,Changshu 215500,China;Department of Neurology,Changshu Hospital Affiliated to Nanjing University of Chinese Medicine,Changshu 215500,China)
出处
《磁共振成像》
北大核心
2026年第1期35-41,91,共8页
Chinese Journal of Magnetic Resonance Imaging
基金
常熟市科技计划(医学应用基础研究)项目(编号:CY202312)。
关键词
急性缺血性脑卒中
血管内治疗
磁共振成像
磁敏感加权成像
磁敏感血管征
acute ischemic stroke
endovascular treatment
magnetic resonance imaging
susceptibility-weighted imaging
susceptibility vessel sign
