毛细血管指数评分在CTA评估急性缺血性脑卒中侧支循环和预后中的应用  

The application of capillary index core in CTA evaluation of the collateral circulation and prognosis of acute ischemic stroke

作　　者：尚凯 张晓星 魏小二[1] 李跃华[1] SHANG Kai;ZHANG Xiaoxing;WEI Xiaoer;LI Yuehua(Department of Interventional Radiology,Affiliated Sixth People's Hospital,Shanghai Jiaotong University,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院放射介入科

出　　处：《介入放射学杂志》2019年第10期930-933,共4页Journal of Interventional Radiology

摘　　要：目的评价毛细血管指数评分(CIS)用于CTA评估急性大脑中动脉或颈内动脉颅内段闭塞患者侧支循环的可靠性及其与预后的关系。方法回顾性分析2016年至2017年收治的33例发病6 h内脑动脉闭塞所致急性缺血性脑卒中(AIS)患者临床和影像学资料,同时完成头颅CT平扫、CTA和脑血管DSA检查。根据CIS标准,分别评估CTA和DSA图像上侧支循环情况,CIS≥2分定义为侧支循环良好(fCIS),<2定义为侧支循环不良(pCIS)。Kappa检验评价两种方法评估侧支循环的一致性,多因素logistic回归分析CTA-CIS与患者预后的关系。结果CTA-CIS和DSA-CIS评估侧支循环具有较高的一致性(K=0.71,P<0.001),CTA-CIS对fCIS诊断准确率为91.3%。Logistic回归分析显示CTA-CIS和入院血糖水平是影响患者远期预后的主要因素。结论CIS用于CTA可评估脑动脉闭塞所致AIS患者侧支循环,预测血管内治疗预后,有助于治疗决策和患者选择。Objective To assess the reliability of capillary index score(CIS)in CT angiography(CTA)evaluation of cerebral collateral flow in acute ischemic stroke in patients with acute middle cerebral artery occlusion or intracranial segment occlusion of internal carotid artery,and to analyzed the relationship between CIS and prognosis.Methods The clinical data and imaging materials of 33 patients with acute ischemic stroke(AIS)caused by cerebral artery occlusion within 6 hours from symptom onset,who were admitted to authors'hospital during the period from 2016 to 2017,were retrospectively analyzed.CT plain scan of head,CTA and cerebral DSA examinations were performed in all patients.According to CIS standard,the collateral circulation presented on CTA and DSA images were separately evaluated.CIS≥2 was defined as fine collateral circulation(fCIS)and CIS<2 was defined as poor collateral circulation(pCIS).Kappa test was used to evaluate the consistency of two methods in scoring collateral circulation.Multivariate logistic regression analysis was used to analyze the relationship between CTA-CIS and prognosis.Results High consistency existed between CTA-CIS and DSA-CIS in evaluating collateral circulation condition(K=0.71,P<0.001).The diagnostic accuracy of CTA-CIS for fCIS was 91.3%.Logistic regression analysis indicated that CTA-CIS and the blood glucose level at admission were the main factors that influence the long-term prognosis of patients.Conclusion CTA-CIS can assess the collateral circulation in patients with AIS caused by cerebral artery occlusion and predict the prognosis of patients after endovascular therapy.Therefore,CTA-CIS is very helpful in formulating therapeutic scheme as well as in selecting appropriate patients.(J Intervent Radiol,2019,28:930-933)

关 键 词：急性缺血性脑卒中 侧支循环 毛细血管指数评分 预后 

分 类 号：R722.15[医药卫生—儿科]