Analysis of predictive efficacy of CT perfusion imaging combined with multi-phase CT angiog-raphy in predicting cerebral edema after mechanical thrombectomy for acute ischemic stroke due to large vessel occlusion
Objective To investigate the predictive efficacy of CT perfusion imaging com-bined with multi-phase CT angiography for cerebral edema after mechanical thrombectomy in a-cute ischemic stroke due to large vessel occlusion(AIS-LVO).Methods A total of 80 patients with AIS-LVO patients who had completed mechanical thrombectomy treatment in the Binhu District of Hefei First People's Hospital from January 2019 to October 2023 were selected.All pa-tients underwent CT perfusion imaging and multi-phase CT angiography diagnosis before opera-tion,and relevant imaging data was collected.Based on the occurrence of cerebral edema within 72 hours after operation,the patients were divided into the occurrence group(n=26 cases)and the non occurrence group(n=54 cases).The predictive efficacy of CT perfusion imaging combined with multi-phase CT angiography for cerebral edema after mechanical thrombectomy for AIS-LVO was analyzed.Results The cerebral blood volume(CBV),cerebral blood flow(CBF),and multi temporal CT angiography scores of the occurrence group before thrombectomy were lower than those of the non occurrence group,and the mean transit time(MTT)and time to peak(TTP)were higher than those of the non occurrence group,with statistical significant differences(P＜0.05).Multivariate Logistic regression analysis showed that preoperative CT perfusion imaging parameters(CBV,CBF,MTT and TTP)and multi-temporal CT angiography scores of AIS-LVO patients were all influencing factors for postoperative cerebral edema(P＜0.05).The receiv-er operating characteristic curve(ROC)was drawn.The results showed that the area under the curve(AUC)of CBF,MTT,TTP and multi-phase CT angiography for predicting cerebral edema after mechanical thrombectomy in AIS-LVO patients was＞0.7,all of which had certain predic-tive value.The combined predictive AUC was 0.963,which had the best predictive value.The sen-sitivity of combined prediction was 96.20％and the specificity was 88.90％.Conclusion The pre-operative CT perfusion imaging and multi-phase CT angiography related parameters of AIS-LVO mechanical thrombectomy have certain predictive value for the occurrence of postoperative cerebral edema in patients,and their combined predictive performance is the best.
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