[1]马圆,李沛城,李青松,等.缺血性脑卒中患者机械取栓术后早期CT平扫脑实质高密度影鉴别诊断[J].介入放射学杂志,2024,33(08):829-833.
　MA Yuan,LI Peicheng,LI Qingsong,et al.Differential diagnosis of post-thrombectomy high-density shadow within the brain parenchyma displayed on early plain CT scan in patients with ischemic stroke[J].journal interventional radiology,2024,33(08):829-833.
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缺血性脑卒中患者机械取栓术后早期CT平扫脑实质高密度影鉴别诊断()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
33
期数:
2024年08
页码:
829-833
栏目:
神经介入
出版日期:
2024-08-12

文章信息/Info

Title:
Differential diagnosis of post-thrombectomy high-density shadow within the brain parenchyma displayed on early plain CT scan in patients with ischemic stroke
作者:
马圆; 李沛城; 李青松; 史慧娟; 刘一之; 陈珑
Author(s):
MA Yuan; LI Peicheng; LI Qingsong; SHI Huijuan; LIU Yizhi; CHEN Long.
Department of Interventional Radiology，First Affiliated Hospital of Soochow University，Suzhou，Jiangsu Province 215006，China
关键词:
【关键词】缺血性脑卒中;  机械取栓术;  CT平扫;  脑出血;  对比剂渗出
文献标志码:
A
摘要:
【摘要】目的探讨鉴别急性缺血性脑卒中机械取栓术后患者早期（24 h内）CT平扫所示脑实质高密度影（PTIH）为脑实质出血或对比剂外溢的影像学特征。 方法回顾性分析77例急性大血管闭塞脑卒中接受机械取栓治疗后早期CT平扫显示脑实质内高密度影患者临床资料。根据术后24～48 h复查CT平扫结果分为脑实质出血组（n=38，43处）和单纯对比剂渗出组（n=39，47处）。观察早期CT平扫图像上机械取栓术后PTIH直接征象（位置分布、最大CT值、体积、密度混杂征）和间接征象（局部占位效应、脑室内高密度、蛛网膜下腔高密度）。采用t检验、Mann-Whitney秩和检验、卡方检验、Fisher精确检验及多因素logistic回归分析两组表现特征差异。 结果脑实质出血组患者比对比剂渗出组患者更容易出现占位效应（28/38比 9/39，P=0.003）及脑室内高密度（5/38比0/39，P=0.025）。新发PTIH灶90处中43处脑实质出血，47处对比剂渗出。进一步多因素logistic回归分析结果显示，脑实质出血组、对比剂渗出组间PTIH体积、密度混杂征判断实质脑出血差异有统计学意义（均P＜0.05），OR值分别为2.93、9.24。PTIH体积诊断脑实质出血的最佳界值为9.3 cm3。 结论占位效应和脑室内高密度可作为判断新发PTIH为脑实质出血的间接征象。PTIH体积≥9.3 cm3和密度混杂征可作为诊断新发PTIH为脑实质出血的直接征象。

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备注/Memo

备注/Memo:
（收稿日期：2023-10-17）
（本文编辑：谷珂）
更新日期/Last Update: 2024-08-08