急性脑梗死磁共振弥散加权成像特征在血管内血栓切除术后颅内出血的预测价值

Value of diffusion-weighted imaging features in predicting intracranial hemorrhage after endovascular thrombectomy in patients with acute cerebral infarction

摘要:

目的 探讨急性脑梗死（ACI）中磁共振弥散加权成像（MRI DWI）特征在血管内血栓切除术（EVT）后颅内出血的预测价值。方法 将2021年8月—2023年12月在宣城市人民医院行EVT治疗的ACI患者107例纳入研究。根据EVT后有无颅内出血分组，收集患者一般资料，计算DWI梗死体积及最大达峰时间（Tmax）。结果 两组患者从发病到入院、EVT及静脉溶栓时间等比较，差异无统计学意义（P＞0.05），但术后颅内出血组空腹血糖（FBG）、糖化血红蛋白（HbAlc）水平及DWI值高于无出血组（P＜0.05）。HbAlc、FBG、DWI梗死体积是预测ACI患者EVT后出血的预测因子（P＜0.05）。结论 ACI中MRI DWI特征、FBG和HbA1c可作为EVT后颅内出血的预测指标，与术后颅内出血发生风险相关。

Abstract:

Objective To investigate the value of MRI diffusion-weighted imaging （MRI DWI） in predicting intracranial hemorrhage after endovascular thrombectomy （EVT） in patients with acute cerebral infarction（ACI）.Methods A total of 107 patients with ACI who underwent EVT in Xuancheng People’s Hospital from August 2021 to December 2023 were enrolled， and according to the presence of absence of intracranial hemorrhage after EVT， the patients were divided into hemorrhage group and non-hemorrhage group. General data were collected， and infarct volume and Tmax on DWI were calculated.Results There were no significant differences between the two groups in the time from disease onset to admission， EVT， and the time of intravenous thrombolysis （P >0.05）， and after treatment， the hemorrhage group had significantly higher fasting blood glucose， HbAlc and DWI value than the non-hemorrhage group （P <0.05）. HbAlc， fasting blood glucose， and DWI infarct volume were predictive factors for hemorrhage after EVT in patients with ACI （P <0.05）.Conclusions MRI DWI features， fasting blood glucose， and HbA1c can be used as predictive factors for intracranial hemorrhage after EVT in patients with in acute cerebral infarction， and these factors are significantly associated with the risk of postoperative intracranial hemorrhage.