% 0期刊文章%莎拉李% Soren克里斯滕森迈克尔Mlynash % %江本%一个马克斯Wintermark %罗纳德·strat % Gabriel Broocks %阿斯特丽德克% Omid Nikoubashman %一个Johannes Trenkler Andrea Morotti % % Markus Mohlenbruch % Jens Fiehler %一个莫里茨Wildgruber %安德烈Kemmling %腻过Psychogios % B彼得。斯波恩% T Hyperacute灌注成像在儿科血栓切除术% B拯救孩子的分析研究% D R 10.1212 / WNL 2023%。0000000000201687 % J首页神经病学% P e1148-e1158 % V 100% N 11% X背景和目标灌注成像能够识别成人脑组织可抢救的患者将受益于血栓切除术在以后的时间窗口。获得hyperacute灌注的可行性序列在儿科中风是未知的。本研究的目的是确定是否对比灌注成像延迟时间治疗和评估灌注概要文件在儿童大血管闭塞中风。方法拯救孩子的回顾性队列研究(2000年1月- 2018年12月)入学儿童(1 month-18年)与中风从27个欧洲和美国接受血栓切除术中风中心。这二次分析包括前循环阻塞的患者,可用神经影像成像直接审查的核心实验室。群体间的比较进行了使用Wilcoxon rank-sum精确测试连续变量或Fisher精确检验二进制变量。考虑到患者,灌注成像评价参数进行描述性的。结果33名患者神经影像,15(45.4%)接受了灌注(CT灌注n = 6;MR灌注n = 9);在技术上都足够了。中位数时间从发病到血管再通组没有差异{4小时(四分位距(差)4 - 7.5)灌注+; 3.4 hours (IQR 2.5–6.5) perfusion-, p = 0.158}. Target mismatch criteria were met by 10/15 (66.7%) patients and did not correlate with reperfusion status or functional outcome. The hypoperfusion intensity ratio (HIR) was favorable in 11/15 patients and correlated with older age but not NIHSS, time to recanalization, or stroke etiology. Favorable HIR was associated with better functional outcome at 6 months (Pediatric Stroke Outcome Measure 1.0 [IQR 0.5–2.0] vs 2.0 [1.5–3.0], p = 0.026) and modified Rankin Scale 1.0 [0–1] vs 2.0 [1.5–3.5], p = 0.048) in this small sample.Discussion Automated perfusion imaging is feasible to obtain acutely in children and does not delay time to recanalization. Larger prospective studies are needed to determine biomarkers of favorable outcome in pediatric ischemic stroke and to establish core and penumbral thresholds in children.ADC=apparent diffusion coefficient; CASCADE=Childhood Arterial Ischemic Stroke Standardized Classification and Diagnostic Evaluation; DWI=diffusion-weighted imaging; HIR=hypoperfusion intensity ratio; IV=intravenous; IQR=interquartile range; LKW=last known well; LVO=large vessel occlusion; mRS=modified Rankin Scale; mTICI=modified Treatment in Cerebral Infarction; pNIHSS=pediatric National Institutes of Health Stroke Scale; PSOM=Pediatric Stroke Outcome Measure; ROC=receiver-operating characteristic; rCBF=relative cerebral blood flow; Tmax=time to maximum tissue residue function; TMM=Target Mismatch %U //www.ez-admanager.com/content/neurology/100/11/e1148.full.pdf