RT杂志文章SR电子T1小儿取栓前超急性灌注成像JF神经学JO神经学FD Lippincott Williams & Wilkins SP e1148 OP e1158 DO 10.1212/WN首页L.0000000000201687签证官100年11 A1莎拉李A1迈克尔Mlynash A1 Soren克里斯滕森A1本江A1马克斯Wintermark A1罗纳德·strat A1 Gabriel Broocks A1阿斯特丽德克A1 Omid Nikoubashman A1 Andrea Morotti A1 Johannes Trenkler A1马库斯Mohlenbruch A1 Jens Fiehler A1莫里茨Wildgruber A1安德烈Kemmling A1腻过Psychogios A1彼得·b·斯波恩年2023 UL //www.ez-admanager.com/content/100/11/e1148.abstract AB背景和目标灌注成像能够识别成人脑组织可抢救的患者首页会在以后的时间窗内从血栓切除术中获益。获得小儿脑卒中超急性灌注序列的可行性尚不清楚。本研究的目的是确定对比灌注成像是否延迟治疗时间，并评估大血管闭塞性卒中儿童的灌注情况。拯救儿童的回顾性队列研究(2000年1月至2018年12月)纳入了27个欧洲和美国中风中心接受血栓切除术的中风儿童(1个月至18岁)。该次要分析包括前循环闭塞患者和可由神经成像核心实验室直接审查的可用成像。组间比较使用连续变量的Wilcoxon秩和精确检验或二元变量的Fisher精确检验。由于患者人数较少，灌注成像参数的评价仅是描述性的。结果33例有神经影像学检查的患者中，15例(45.4%)行灌注(CT灌注n = 6;MR灌注n = 9); all were technically adequate. The median time from onset to recanalization did not differ between groups {4 hours (interquartile range [IQR] 4–7.5) perfusion+; 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

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