@article {Faizye2296作者= {Tobias Djamsched Faizy和迈克尔Mlynash Reza卡贝里和索伦克里斯滕森加布里埃尔玛丽Kuraitis马吕斯·m·马德尔和费边Flottmann Gabriel Broocks Maarten g . Lansberg和格里高利·w·阿尔伯斯和迈克尔·p·标志和Jens Fiehler和Max Wintermark和杰里米·j·海特},标题={大脑抵押品级联},体积={98}={23},页面= {e2296——e2306} = {2022}, doi = {10.1212 / WNL。出版商0000000000200340}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={背景和目标健壮的脑络脉与良好的结果在急性缺血性中风患者由于大血管闭塞治疗血栓切首页除术。然而,抵押状态评估主要依赖于单一成像生物标志物和更全面的整体方法可能提供更深入的洞察抵押品灌注的生物医学成像。综合collateralization被定义为脑动脉的血液流动脑组织和引流静脉。我们假设一个全面的分析脑动脉抵押品级联(CCC),组织,和静脉水平预测的临床和影像学结果。这是一个多中心回顾性队列研究方法的急性中风患者发生血栓切除术分流。CCC是由量化软膜的动脉络脉,组织层面络脉,和静脉流出(VO)。软膜的动脉络脉是由CT血管造影术;CT灌注组织水平络脉进行评估。签证官在CT血管造影评估使用皮质静脉不透明的分数。三组被定义:CCC +(好软膜的络脉,组织层面络脉,和签证官),CCC -(可怜的软膜的络脉,组织层面络脉,和签证官),和CCCmixed(其余的病人)。主要结果是功能独立(改良Rankin量表得分0 {\ textendash} 2)在90天。 Secondary outcome was final infarct volume.Results A total of 647 patients met inclusion criteria: 176 CCC+, 345 CCCmixed, and 126 CCC-. Multivariable ordinal logistic regression showed that CCC+ predicted good functional outcomes (odds ratio [OR] 18.9 [95\% CI 8{\textendash}44.5]; p \< 0.001) compared with CCC- and CCCmixed. CCCmixed patients likely had better functional outcomes compared with CCC- patients (OR 2.5 [95\% CI 1.2{\textendash}5.4]; p = 0.014). Quantile regression analysis (50th percentile) showed that CCC+ (β -78.5, 95\% CI -96.0 to -61.1; p \< 0.001) and CCCmixed (β -64.0, 95\% CI -82.4 to -45.6; p \< 0.001) profiles were associated with considerably lower final infarct volumes compared with CCC- profiles.Discussion Comprehensive assessment of the collateral blood flow cascade in patients with acute stroke is a strong predictor of clinical and radiologic outcomes in patients treated by thrombectomy.ASPECTS=Alberta Stroke Program Early CT Score; CCC=cerebral collateral cascade; AIS=acute ischemic stroke; HIR=hypoperfusion intensity ratio; ICA=internal carotid artery; IQR=interquartile range; LVO=large vessel occlusion; M1=first segment of the middle cerebral artery; M2=second segment of the middle cerebral artery; mRS=modified Rankin Scale; mTICI=modified Thrombolysis in Cerebral Infarction; NIHSS=National Institutes of Health Stroke Scale; OR=odds ratio; Tmax=time to maximum; VO=venous outflow}, issn = {0028-3878}, URL = {//www.ez-admanager.com/content/98/23/e2296}, eprint = {//www.ez-admanager.com/content/98/23/e2296.full.pdf}, journal = {Neurology} }