[1]万栋栋,刘 华,王 超,等.T2W-FLAIR序列高信号血管征预测颈动脉支架植入术后脑过度灌注综合征——单中心前瞻性队列研究[J].介入放射学杂志,2026,(03):259-265.[doi:10.3969/j.issn.1008-794X.2026.03.004 ]
　WAN Dongdong,LIU Hua,WANG Chao,et al.Application of T2W-FLAIR hyperintense vessel sign in predicting cerebral hyperperfusion syndrome after carotid artery stenting:a single-center prospective cohort study[J].J Intervent Med,2026,(03):259-265.[doi:10.3969/j.issn.1008-794X.2026.03.004 ]
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T2W-FLAIR序列高信号血管征预测颈动脉支架植入术后脑过度灌注综合征——单中心前瞻性队列研究()

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

卷:
期数:
2026年03
页码:
259-265
栏目:
神经介入
出版日期:
2026-03-25

文章信息/Info

Title:
Application of T2W-FLAIR hyperintense vessel sign in predicting cerebral hyperperfusion syndrome after carotid artery stenting:a single-center prospective cohort study
文章编号:
1008-794X(2026)-003-0259-07
作者:
万栋栋;  刘 华;  王 超;  闫莉婷;  吴 涛;  喻 俊;  李 阳;  郑金平
753000 宁夏石嘴山 石嘴山市第二人民医院神经外科
Author(s):
WAN Dongdong; LIU Hua; WANG Chao; YAN Liting; WU Tao; YU Jun; LI Yang; ZHENG Jinping; LI Dong; LUO Jing.
Department of Neurosurgery,Shizuishan Municipal Second People's Hospital,Shizuishan,Ningxia Hui Autonomous Region 753000,China
关键词:
颈动脉支架植入术;  脑过度灌注综合征;  高信号血管征;  动脉自旋标记;  磁共振成像
分类号:
R654.3
DOI:
10.3969/j.issn.1008-794X.2026.03.004
文献标志码:
A
摘要:
目的 验证MRI T2加权液体衰减反转恢复(T2-weighted fluid-attenuated inversion recovery,T2W-FLAIR)序列高信号血管征(hyperintense vessel sign,HVS)分级对颈动脉支架植入术(carotid artery stenting,CAS)后脑过度灌注(cerebral hyperperfusion,CHP)的预测效能,以提供一种无创、简便且易普及的替代预测工具,解决基层医院单光子发射计算机断层成像术(single-photon emission computed tomography,SPECT)低普及率问题。方法 采用前瞻性单中心队列研究设计,连续纳入2021年1月至2024年12月在石嘴山市第二人民医院接受CAS术100例症状性颈动脉重度狭窄患者。术前1.5T MRI评估HVS分级,术后1周采用MR伪连续动脉自旋标记(pseudo-continuous arterial spin labeling,pCASL)量化脑血流量(cerebral blood flow,CBF)。采用多因素logistic回归分析确定CHP独立预测因子。主要终点为影像学CHP(患侧CBF增幅较术前>100%)及30 d内脑过度灌注综合征(cerebral hyperperfusion syndrome,CHS)发生率。结果 38例(38.0%)患者发生CHP。多因素logistic回归分析显示,HVS分级≥2级(OR=7.92,95%CI=3.45～18.18)、Willis环缺损(OR=4.05,95%CI=1.78～9.21)是CHP独立预测因子。两者联合预测模型的曲线下面积(AUC)为0.91,灵敏度为86.8,特异度为88.7,阴性预测值为93.2。CHS仅发生于CHP组(13/38,34.2%比0,P<0.001)。结论 T2W-FLAIR序列HVS分级联合Willis环评估是一种预测效能良好的无创替代工具,可有效识别CAS后CHS高危患者,有助于指导术后早期强化血压管理,对于SPECT设备短缺的基层医院优化资源配置具有重要价值。

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(收稿日期:2025-08-03)
(本文编辑:谷 珂)

相似文献/References:

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　ZHAO Wanyu,Du Ganqin,DUAN Peiyang,et al.The effect of carotid artery stenting on the cognitive function of patients with carotid artery stenosis: a meta-analysis?[J].J Intervent Med,2020,29(03):129.
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备注/Memo

备注/Memo:
基金项目: 宁夏卫生健康系统青年培育项目(2024-NWQP-B097)
通信作者: 王 超 E-mail:15055530@qq.com
更新日期/Last Update: 2026-03-25