Evaluation of Prognosis of Acute Middle Cerebral Artery Occlusion by Endovascular Treatment Therapy Based on Imaging Features of Thrombotic Permeability
Objective To investigate the relationship between thrombus attenuation increase(TAI)and clinical prog-nosis in patients with acute occlusion of middle cerebral artery undergoing endovascular treatment(EVT).Methods The data of 58 patients with acute ischemic stroke with middle cerebral artery occlusion and EVT treatment in Cardio-Cerebro-vascular Disease Hospital Affiliated Hospital of Yan an University were retrospectively analyzed.The 90-day modified Rankin scale(mRS)score was used as the dependent variable to divide the patients into two groups:32 cases in the good prognosis group(mRS ≤2)and 26 cases in the poor prognosis group(mRS＞2).Univariate and multifactor stepwise lo-gistic regression was used.Independent risk factors for poor prognosis after EVT treatment were screened and determined,and the efficacy of each risk factor in the prognosis assessment of AIS patients was analyzed by ROC curve.Results Mul-tivariate Logistic regression results showed that TAI,thrombus density and thrombus length were independent risk factors for 90-day mRS Prognosis in patients with acute middle cerebral artery occlusion and intravascular therapy(P＜0.05).ROC curve analysis showed that the AUC of TAI was 0.861 and the optimal cutoff value was 10.85,and the thrombus density AUC was 0.655 and the optimal cutoff value was 4.181.The AUC of thrombus length was 0.665,and the optimal cut-off value was 1.78.The AUC of TAI,thrombus length and thrombus density was 0.911.Conclusion Patients with acute mid-dle cerebral artery occlusion who underwent intravascular therapy with good 90-day mRS Function prognosis(mRS≤2)had higher TAI and higher thrombus permeability,and TAI had better sensitivity and specificity for 90-day mRS Function prog-nosis prediction.TAI,thrombus density and thrombus length,as a joint imaging index,have good sensitivity and specificity in predicting the prognosis of 90-day mRS Function,and are a good joint imaging biological predictor.
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