MRI在急性脑梗死患者血管内血栓切除术后颅内出血的预测价值  

Predictive Value of MRI in Intracranial Hemorrhage after Intravascular Thrombolectomy in Patients with Acute Cerebral Infarction

作　　者：郭群[1] 吴含[1] 陆小妍 郭静丽[1] 高伟[1] 张媛[1] GUO Qun;WU Han;LU Xiao-yan;GUO Jing-li;GAO Wei;ZHANG Yuan(Department of Radiology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,Jiangsu Province,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)医学影像科,江苏南京210006

出　　处：《中国CT和MRI杂志》2024年第5期1-3,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨MRI在急性脑梗死患者进行血管内血栓切除术(EVT)后颅内出血(ICH)的预测价值。方法回顾性分析接受EVT治疗的急性脑梗死患者67例,收集这些患者的弥散加权成像(DWI)、灌注加权成像(PWI)和DWI-PWI不匹配(DPM)的体积以及其他临床相关数据,ICH由非增强CT评估。采用多元logistic回归分析预测急性脑梗死患者治疗后的ICH。结果接受EVT后,ICH的患者空腹血糖[(11.96±1.93)mg/L与(13.26±1.73)mg/L]、HbA1c[(5.73±0.42)%与(6.21±0.49)%]、DWI梗死体积(51.23±41.32 ml与29.61±32.26ml)显著大于无ICH的患者(t=-7.693,P<0.001;t=6.135,P<0.001;t=-2.531,P=0.016)。多变量逻辑回归分析显示血糖[OR(95%CI):1.312(1.145~1.417),P<0.001]、HbA1c[OR(95%CI):38.847(7.216~201.753),P<0.001]以及DWI梗死体积[OR(95%CI):1.021(1.004~1.034),P=0.016]为预测急性脑梗死患者EVT术后ICH独立的预测因子。结论急性脑梗死患者行EVT治疗后,通过检测患者的空腹血糖、HbA1c和DWI梗死体积能够预测ICH的发生风险,从而对后续的临床治疗提供信息。Objective To investigate the predictive value of MRI in intracranial hemorrhage(ICH)after intravascular thrombolectomy(EVT)in patients with acute cerebral infarction.Methods Sixty-seven patients with acute cerebral infarction treated with EVT were retrospectively analyzed.Volume of diffusionweighted imaging(DWI),perfusion weighted imaging(PWI),and DWI-PWI mismatch(DPM)as well as other clinically relevant data were collected from these patients.ICH was assessed by unenhanced CT.Multiple logistic regression analysis was used to predict ICH in patients with acute cerebral infarction after treatment.Results After receiving EVT,Fasting blood glucose[(11.96±1.93)mg/L and(13.26±1.73)mg/L],HbA1c[(5.73±0.42)%and(6.21±0.49)%],DWI infarct volume(51.23±41.32 ml and 29.61±32.26ml)in ICH patients were significantly higher than those without ICH(t=-7.693,P<0.001;T=6.135,P<0.001;T=-2.531,P=0.016).Multivariate logistic regression analysis showed that blood glucose[OR(95%CI):1.312(1.145-1.417),P<0.001],HbA1c[OR(95%CI):38.847(7.216-201.753),P<0.001]and DWI infarct volume[OR(95%CI):1.021(1.004-1.034),P=0.016]were independent predictors of ICH after EVT in patients with acute cerebral infarction.Conclusion After EVT treatment,fasting blood glucose,HbA1c and DWI infarct volume can predict the risk of ICH,thus providing information for subsequent clinical treatment.

关 键 词：急性脑梗死 弥散加权成像 灌注加权成像 颅内出血 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.32[医药卫生—诊断学]