Objective The aim of this study was to explore the feasibility of nomograms in predicting diffusion weigh-ting imaging(DWI)negative acute ischemic stroke(AIS).Methods The clinical and radiological data of AIS patients who underwent recombinant tissue-type plasminogen activator(rt-PA)intravenous thrombolytic therapy in our hospital from January 2020 to December 2022 were retrospectively collected.DWI positivity was defined as group A(n=187)and DWI negative as group B(n=49),univariate analysis compared the general clinical data and radiological data of the two groups,and the parameters with statistical differences were included in the binary Logistics regression analysis,and the independent risk factors for predicting DWI-negative AIS were screened and a nomogram model was established.The diagnostic efficacy of the receiver operator characteristic curve(ROC)was evaluated by the independent risk factors of AIS and the nomogram prediction model for all predictions of DWI negative.Results The blood glucose and pre-thrombolytic national institute of health stroke scale(NIHSS)of patients in group A were greater than those in group B(P＜0.05),the Alberta stroke pro-gram early CT Score(ASPECTS)before thrombolysis in group A were smaller than those in group B(P＜0.05),and the 90-day prognosis of patients in group B was significantly better than that of patients in group A(P＜0.05).The results of the binary Logistics regression equation showed that the ASPECTS before thrombolysis,the NIHSS before thrombolysis,and blood glucose were independent risk factors for predicting DWI-negative AIS,and the area under the ROC of the nomogram model was 0.828,and the threshold was 0.0056,the sensitivity and specificity were(90.4％and 92.4％).Conclusion The prognosis of intravenous thrombolytic therapy in patients with DWI-negative AIS is significantly better than that of pa-tients with DWI-positive AIS,and the nomogram model based on pre-thrombolytic ASPECTS,pre-thrombolytic NIHSS and blood glucose can effectively predict DWI-negative AIS,and provide clinical evidence of intravenous thrombolysis for AIS patients who cannot undergo MRI examination.
维普
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