% 0期刊文章%彭王% Wenhuo Andrew Bivard陈% Chushuang陈% %耿于%哈哈林马克•帕森斯(george w . bush) % %代表激励% T协会灌注损伤变量与功能结果轻度中风患者和大血管阻塞管理医学% D R 10.1212 / WNL 2023%。0000000000201498 % J首页神经病学% P e627-e638 % V 100% N 6% X背景和目标的最佳管理轻度中风患者和大血管闭塞(LVO)仍不清楚。本研究旨在确定灌注成像差的预测功能结果在这样的病人。这个回顾性队列研究方法选择国际中风病人的灌注成像注册中心在2011年8月和2022年4月。注册表注册急性缺血性中风患者和基线CT灌注扫描发病24小时内的。本研究发现患者症状轻微,定义的NIH卒中量表评分≤5。患者LVO前循环。本研究进一步选择病人的医疗管理和排除患者接受血管内治疗。主要结果是贫穷的功能性结果定义为改良Rankin规模的3 - 6 3个月。灌注损伤是由延迟时间> CTP 3秒。回归分析用来确定临床和影像变量预测功能差的结果。结果共有139例轻度中风患者,其中27例(19%)有可怜的功能结果。 Patients with poor outcome, compared with those with good outcome, had much larger perfusion lesion volume (median 80 mL vs 41 mL, p < 0.001). Perfusion lesion was a significant predictor of poor outcome in either univariable regression (crude OR = 1.02, 95% CI = [1.01–1.03]) or multivariable regression model (adjusted OR = 1.01, 95% CI = [1.01–1.02]), adjusting for occlusion site, good collaterals, baseline stroke severity, age, IV thrombolysis (IVT), and onset to scan time. A perfusion lesion of 65 mL was the optimal cutpoint to identify poor functional outcome (sensitivity = 59%, specificity = 77%). Patients with perfusion lesion ≥65 mL, compared with patients with perfusion lesion <65 mL, showed a much higher rate of poor functional outcome (38% vs 11%, p < 0.001). Of the 139 patients in this study, 95 received IVT. Patients treated with or without IVT did not influence their outcomes (crude OR = 0.74, 95% CI = [0.31–1.78]).Discussion A perfusion lesion of ≥65 mL predicted poor functional outcome in mild stroke patients with LVO.ASPECTS=Alberta Stroke Program Early CT Score; CBF=cerebral blood flow; CTP=CT perfusion; DT=delay time; EVT=endovascular thrombectomy; INSPIRE=International Stroke Perfusion Imaging Registry; IVT=IV thrombolysis; LVO=large vessel occlusion; NCCT=noncontrast CT; NIHSS=NIH Stroke Scale; PH=parenchymal hemorrhage; sICH=symptomatic intracerebral hemorrhage %U //www.ez-admanager.com/content/neurology/100/6/e627.full.pdf

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