陈广浩;邱建博;郑少青;殷信道;彭明洋;马跃虎;

• 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

摘要(Abstract)：

目的探讨磁共振血管造影(magnetic resonance angiography,MRA)中侧枝血管与急性卒中机械取栓术后预后间的关系。材料与方法前瞻性纳入接受机械取栓治疗的急性卒中患者。所有患者均于治疗前及治疗后24 h内接受头颅MRI平扫和MRA检查。3个月后的预后情况根据改良Rankin量表(modified Rankin Scale,mRS)评估,mRS0～2为预后良好组,mRS3～6为预后不良组。统计学方法分析预后良好组与不良组之间侧裂及软脑膜的侧枝血管的差异。结果共55例动脉闭塞的卒中患者纳入分析(侧裂侧枝血管不丰富者52例,软脑膜侧枝血管不丰富者45例)。侧裂血管和软脑膜血管不丰富的患者,预后良好组的入院NIHSS评分(10.06±4.65 vs 14.25±4.91;P=0.006)、术前梗死体积(13.61±10.99 vs 59.80±92.74;P=0.006)均低于预后不良组。多元逻辑回归分析显示年龄、软脑膜的侧枝循环是预测预后的独立预测因子(OR=1.094,95%CI=1.025～1.168,P=0.007;OR=9.542,95%CI=1.812～50.245,P=0.008)。预后良好组的梗死增长体积(术前vs术后:14.15±10.73 vs 21.39±17.41)小于预后不良组(术前vs术后:16.88±16.64 vs 57.27±56.67),然而多元逻辑回归分析显示术后梗死体积对预测卒中预后无显著意义(OR=1.094,95%CI=1.025～1.168,P=0.154)。结论磁共振血管造影侧枝血管可用于评估卒中预后,尤其是软脑膜的侧枝循环可预测卒中预后,而术后卒中梗死体积与预后的关系仍需进一步研究。

关键词(KeyWords)： 卒中;侧枝循环;机械取栓治疗;磁共振血管造影;磁共振成像

Abstract:

Keywords:

基金项目(Foundation): 江苏省科技发展计划项目(编号：BE2017614)~~

作者(Author): 陈广浩;邱建博;郑少青;殷信道;彭明洋;马跃虎;

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参考文献(References)：

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