基于机械取栓术前CTA的侧支循环评分对动脉粥样硬化狭窄型急性大脑中动脉闭塞的预测价值  

Application of CT angiography collateral circulation score before mechanical thrombectomy in predicting acute middle cerebral artery occlusion due to atherosclerotic stenosis

作　　者：徐志嘉 曹月洲[1] 赵林波[1] 贾振宇[1] 鲁珊珊[2] 施海彬[1] 刘圣[1] XU Zhijia;CAO Yuezhou;ZHAO Linbo;JIA Zhenyu;LU Shanshan;SHI Haibin;LIU Sheng(Department of Interventional Radiology,First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu Province 210029,China)

机构地区：[1]南京医科大学第一附属医院介入放射科,江苏南京210029 [2]南京医科大学第一附属医院放射科,江苏南京210029

出　　处：《介入放射学杂志》2023年第2期114-118,共5页Journal of Interventional Radiology

摘　　要：目的 探讨预测急性大脑中动脉M1段闭塞患者动脉粥样硬化型狭窄性闭塞(intracranial atherosclerotic stenosis-related occlusion,ICAS-O)的相关因素。方法 回顾性分析2020年1月至2021年12月于我院接受机械取栓治疗并取得再通的急性大脑中动脉M1段闭塞患者。收集患者的临床及影像学资料,并使用CTA进行侧支循环评分。采用单因素分析及多因素回归分析,探究ICAS-O的相关预测因素。结果 最终纳入患者109例,其中37例(33.9%)为ICAS-O。多因素分析显示,较好的侧支循环(OR=5.343,95%CI=1.969~14.497,P=0.001)、吸烟史(OR=4.655,95%CI=1.384~15.653,P=0.013)患者合并ICAS-O的比例较高;而心房颤动(房颤)病史(OR=0.188,95%CI=0.064~0.555,P=0.002)是ICAS-O阴性预测因素。结论 较好的侧支循环及吸烟史是急性大脑中动脉M1段闭塞患者合并ICAS-O的阳性预测因素,而房颤病史是其阴性预测因素。ObjectiveTo explore the related factors for predicting intracranial atherosclerotic stenosis-related occlusion(ICAS-O)in patients with acute occlusion of the M1 segment of middle cerebral artery.MethodsThe clinical data and imaging materials of the patients with acute occlusion of the M1 segment of middle cerebral artery,who received mechanical thrombectomy and achieved recanalization at the First Affiliated Hospital of Nanjing Medical University of China between January 2020 and December 2021,were retrospectively analyzed.The collateral circulation was assessed with CT angiography(CTA).Univariate analysis and multivariate regression analysis were used to evaluate the relevant predictors for ICAS-O.ResultsA total of 109 patients were enrolled in this study,and in 37 patients among them(33.9%)diagnosis of ICAS-O was confirmed.Multivariate analysis showed that a higher proportion of ICAS-O was observed in patients who had a richer collateral circulation(OR=5.343,95%CI=1.969-14.497,P=0.001)and a smoking history(OR=4.655,95%CI=1.384-15.653,P=0.013),while the history of atrial fibrillation(OR=0.188,95%CI=0.064-0.555,P=0.002)was a negative predictor for ICAS-O.ConclusionIn patients with acute occlusion of the M1 segment of middle cerebral artery,a richer collateral circulation and a smoking history are the positive predictors for ICAS-O,while atrial fibrillation is a negative predictor.

关 键 词：CTA 侧支循环 急性大血管闭塞性卒中 机械取栓 动脉粥样硬化型狭窄 

分 类 号：R743.3[医药卫生—神经病学与精神病学]